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HomeMy WebLinkAboutBuilding Permit Application f< ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:All Permit Number: i= Building Permit Application P. Planning and Development Services JUL 12. 6 29'17 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 PE�.yi I'�� 3" 5t. Lucie County, FL Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: p To Select from dro box, click arrow at the end of line plin; Address: ,33 4 ( .500;tt 57� Legal Description: Property TaxID#: Z yZ� ,3�� (7®® � ©®o �� Lot No. Site Plan name: Block No. Project Name: i. Setbacks Front Back: Right Side: Left Side: i7/// ,�� 5) /zs z,sa v' , s i Addition 11Kto1bPfe1D"rrorMecl uner is permrt—c ec a appy: HVAC Gas Tank —]Gas Piping Shutters Q Windows/Doors i. Electric 0 Plumbing ❑Sprinklers Generator Roof is Total Sq. Ft of Construction: S .Ft.of First Floor: UiL Cost of Construction:$ fll Utilities: _Sewer E]Septic Building Height: Name i' C g(bo)C'�F-- t�E5r— LL.L Name: 517-If TI) �X EA#14 Address: 2—416 121 zw <fxi6Lt_ Company: ��Q � EL ci�C City:t&4, ''1 hL State:_C Address: 5& ® Zip Coder 3`l, Fax: City: Pcv r S1- Lk_'Cl State:,r5C" is Phone No. 17 &� Zip Code:3�('7M Fax:'777-.!;`✓0"7V7-5 ` r E-Mail:71Iy.l zZ 1 Q I e Q.MMI�_ , GQCY) Phone No. 772 0/?9" Fill in fee simple Title Holder on next page(if different E-Mail: b ' 1 (A from the Owner listed above) State or County License: 'FC_ 3d 0,3` 15— i LC_ If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i= 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: I certify that no work or installation has commenced prior to the issuance of a permit. k St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure i which is n conflict with any applicable Home Owners Association rules,bylaws or ancovenants 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 yo g intend to obtain financing, consult with lender or an attorney before commencing worAor recordinwour Notice of Commencement. S Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDt. STATE OF FLORIDA cs+, COUNTY OF COUNTY OF The forming instwe t was acknowledged before me The forgo ng instrum n was acknowledged before me 20 by this by this P"Ma of 10 3ayof>' RJM y 20 0 (Name of person ackn edgl9g) (Name of person ackno ed -Asitgature of Notary-Pub f-ic-State of FloridaNotary PuEilic-State of Florida Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatio i P'� 'd ,oftType of ldentIficat9;i-Pwd­G A W. TOR11 L;WARNER TORI L.WARNER My COMP SMON#FFS09394 Commission No. RAV Commission No. October COMMIS&A FF909394 S October 11,2019 EXPIRES October 11,2019 (401)3N-0 53 FlorldalloteryServkexom room Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALSf. ti,