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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: '� L�'�� Permit Number: Building permit Applecati®n Planning and Development Services PERI iIl71NG Building and Code Regulation Division St. LL,Cie C0L;rt�; FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: Window/door FROPSED INPRaVEMEIIT LC3CATIt3N Address: 4_+(31 Sy6us�-1` Q W D Fo(LT P(tfpCiF- Legal Description: a-w V-t\JE)C- E5T1'� s tcT i� Property Tax ID#: 3Lt02 600, �L} 000 Lot No. Site Plan Naine: 5 1 K S Block No. y(3 a. Project Name: 15?0 i2S Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION7F WQRI s YZ PLACE )1 w 1 fPrr-T. fio*V__ CONSTRUCTION INFORIUTATION � r. r Additionalwork toe e orme under this permit—check a appy: HVAC E] Gas Tank F]Gas Piping _Shutters L'i Windows/Doors 11 Electric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$- 1 5,92to Utilities: _Sewer[]Septic Building Height: 11• 2 77 OWNER/LESSEE CONTRACTOR Name boNiJN' 125 Name: WAYNV —tha A-3 f,-;,0P-tsETT Address: 4--7ol SuN567 13W17 Company: "r1 1A City: Do T fte-cg State: :�F& Address: _3044 SW i-IZN1] 5-i" � Zip Code: Fax: City: H-L' , WOOD State: fir, I Phone No. -1--�L Zip Code: Fax: E-Mail: Phone No. OtSq 4�6 Fill in fee simple Title Holder on next page(if different E-Mail: *Ft;�)t5& :F0 'N '?P -Du cls. C"Lk from the Owner listed above) State or County License: C5C,(%19M4 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 5tJPPLE"MENTAL CONSTk" is ON LIE1� LA11V INFORMAT 10N T DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: —Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: 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,perform 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 commencing work or recording our Notice of Commencement. Signature of Owner/Agent/Les e Sign r o ctor/License Holder STATE OF FLORIDA ` STATE OF FLORIDA COUNTY OF_"?�a,,���cA COUNTY OF 3ri)"prA The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of.3,�Que 20©by this 31 day of 20[El by -r'�)OS"' W (Name of person ac owledging) (Name of p rson acknowledging) (Sig re Notary-Public- ate of Florida) (Signa ure o otary Public-St to of Florida) Personally Known OR Produced Identification Personally Known Le""' OR Produced Identification Type of Identification Produced Type of Identification Produced (Seal) N Commission No. - L LUNN Commission No. ) p329g5 Jp.i�1 k IUt j *GG03299 MPr1,sS �pN� g10N# ZOZO EXPti2E5;tiugus ""`C M.�CD �s IN Revised 07/15/20.14 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED