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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: -5- 5l X17 Permit Number: - -1:J 1 zi Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine III Address: Legal Description: TENT L.00AT[ON-i: . t46-1 Property Tax ID #: M51— 000-7 Lot No. Site Plan Name: Block No. Project Name:rlAKKI 2 Setbacks Front Sack: Might Side: Left Side: DETAIL't0:1381CRIPTION E3F'i�HIrJRI�. L,tr.PVTF_ f. w` STCRE S _40J (3irL-ErS Inl M, S ie(Z )G A-1Jb 4 i 11'1.) G UES 1 Gr-N-TH, 96P,j..Ace eXq,�Tos i rAtj_S., MSTRU CTI ON 1NI FORMA I ON Etiana wor to e e orme un er t is permit - check a appy. ®EIVAC [] Gas Tani€ F_JGas Piping _ Shutters Q Windows/Doors LSI Electric 1:1 Plumbing Sprinklers 01 Generator 0 Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor. Cost of Construction; $ 1300 00 Utilities: 11 Sewer LJSeptic Building Height: OWNER/LESSEE: C©NTRAGTQR; Name Address: Name: APVok r—46L MA W Company: AC'C[ RA-rE F AJgfA-1 &AiMACfAX,/+l/C City: - Pt`1'LJm C+ f _ _ State: f Zip Code:3J JO 0 Fax: Address: --10-3 - Gol'laV-1 P_ City: P�> 1 L.vCt State: Ft - Phone No. ZipCode: -5 4 i5.x Fax: E -Mail: Phone No. 72&-37(3 ._5- 75:5 Fill in fee simple Title Holder on next page ( if different E -Mail: fJCi-Knn1C►4 4-M &vEr from tate Owner listed above) State or County License: f -C 000307 a it value of construction is 5Z5UO or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, per -Form the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencinw"ork or recording vour Notice of Commencement.,,7 ___7 Signatufi; of Owner/,entf Lessee STATE OF FLORI COUNTY OF The forgoing instrument was acknowledged before me this '3( day of ' � �, 20_L by (Name o Krson acknowle ing ) i � 1 (Signature of Notary Public- 51 Personally Known 0`` OR Type of Identification Produce Commission No. FF4n `f My.. I* ; iseparr S O ;_ i P OO192 REVIEWS I COO TER NT I ZONWWREVI r��}i'I" RTRVIS EVIEW RECEIVED DATE COMPLETED re of Cr}iitractor/License Holder STATE OF FLORIDA,'' COUNTY OF The forgoing instrument was acknowledged before me this day of ems` ,20/_ by (Name of person acknow dging ) (Signature of Notary Public ate of Florida) �jai9391i 1,i Personally Known � _ OR Produces � VV Type of Identification Produced- -0 roduced 4 •'��t�»Slo�y YP Commission No.f-0�1,511 =z :_ #Ifaas192 o PLANS I VEGETATION I SEA TURT REVIEW REVIEW REVIEW &IT4 �E WI'E sSE Goy- P).A-rA m oc,K