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HomeMy WebLinkAboutbuilding permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ­7 ��� �] Permit Number: Building Permit Application Planning and Development Services Building and Cade Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1S78 Commercial Residential PERMIT APPLICATION FOR: , PRSF - `�! T L TIC Address: Legal Description: f aA-\eL,-�COA �PCLv LkK + -1 10 Lo+ i Property Tax ID#: L, - ( ' "A Lot No. `7 Site Plan Name: Block No. �L Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: sp_y- - 19 Q 3(o f ,fir S �Lp C I L( rtrona wor to e per Dimed under this permit-c ec a t at app y: '!'Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors —Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: �� _- �) Utilities: Sewer Septic Building Height: Cost of Construction: $�, i — � p � g g a UFA Name �b �' �lf ,t� elf5 Address: ©' l -."-vA - 1�.->t ` , Company: e✓s ", �► n QCc City: E -4- A State: F I• Address: �. � a��� I Zip Code: Fax: City: #0;eN-c _ State:_0_- Phone No,.7•_7 o 5 P c1 Zip Code: LI�� Fax: 7�a � E-Mail: Phone No 7 - oZ 3 3_� Fill in fee simple Title Holder on next page [if different E-Mail !1 i/ Cc l n a' C LO •Ccm from the Owner listed above) State or County License K '11-b L{)4 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ti.PQot Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: LANot 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 ins ction_. If you intend to obtain financing, consult with lender or an attorney before commencing w or r-e' rriina Ninim Notice of Commencement. i S ure o wner/Lessee/Agent na Contractor/License Holder STATE OF FLORJ,QA STATE OF FLORIDA I COUNTY OF �—Lc� — COUNTY OF 'N, The forgoing instrument was acknowledged before me The forgoing instw ,ent was acknowledged before me this .day of M 20JJ by this -day of J_i�� _ 20�1 by C) 0ir\r S_ �A JAeV- aamlo,_ e (Name of person ackno ledging} (Name of person acknowledge ) e,��ti11i111111N��r� ` �11NR��N�yr�rr � R '1`IiRiV(�yyR•� �. ✓� (Signature of Notary Publi -St `f*F SABR I (signature of Notary Public-State a o�� Ai Sip �� IAA L. SA H R I NA L. BJ AC K :;��°�,uv a,�,a��: r ✓ EF Personally Known ✓ OR ProrB(*e c�c�ntificat�i� ,_s Personally Known -OR Pco�ent�i t� ion: Type of Identification ��• �#FF 1195337 * Type oi�lddentrfication '���F� ;f`.a�y...161kN S�vb Produced • ' Qo " `z� ilh�111 ������ �9 •,�2p edshN � :�ti+ r �_ � �G t�°�9�`: Commission No. F 9 6 7 (Seal) Commission No. r !Hr(It1115155©1��R`` VREVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW RECEIVED DATE COMPLETED ev. 1