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HomeMy WebLinkAboutBuilding Permit Application ALL APP ICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /) Date: Permit Number: E L43"E I V E Budding Permit Application AUG 0 4 2017 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 _ Rglential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lineyd J Address: I pp �11 \7�7 �7 1 ) Legal (_L` y� ! (�U1 Property Tax ID#: 0 Ca�+q o 6 0 - Lot No. Site Plan Name: Block No. Project Name: IAC -o u) � Setbacks Front �T Back: Right Side: Left Side: -6T )�)aAd Wcuu Pactaq URL in 11 1 1 rt ona wor o e e orme under this permit—check a appy: [RqV_� Gas Tank ❑Gas Piping _Shutters Windows/Doors L_I Electric 0 Plumbing ❑Sprinklers FI Generator ❑Roof Total Sq.Ft of Construction: 5Ft.of First Floor: Cost of Construction:$ �.� utilities"nSewer 11 Septic Building Height: ir Name f Name: J . ), "l t^i:- Address: rmoB son+cj -a Company: Q I ARIMOPAJ A,e C e c, City: F� Pt-e_f'0_Q_ State:[ Address: C'I''C Zip Code: J��'?�5Fax: City:����r'���' ,fes.[ State:' ,c Phone No.!I'l 2,-nH Zip Code: r_. � FaX: R-7 g-61q4 E-Mail: Phone No. S 7? 61 e Fill in fee simple Title Holder on next page(if different E-Mail: fZ U from the Owner listed above) State or County License: A CD r" r-79 LS If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. MENG iNEER; Not App icahls MORTGAGE CAMPA€�t; fa Applicable Name: -,_ Name: Address: Address: city tef C!ty zip: r �- _Phtae' Zip: FEE SIMPLE TiTILE HQI DEA: Not Applicable BONDING CClNii�ANE , � Not Applicable Name: � Address: AdGlress., City . —....,. ci t!' .. ..... Zip' _ Phs�ne;. .. _ Zip; ,.•- .. ..•-, - -- - .,.�- —�, ,, -. -t 1 certify that no work or instailatign has cornmenced prior to the issuance of a permit. St.Lucie bounty makes;ra representation that is granting a permitwill euthorixg the permit hvldgr to wild the sl4bject sir}zct;�ra which is in eon,liet with anyr pplicablR Home Owners fisspciatinn pules,byia�++s ar anis co��nants the f may r $tri t or pr=it ttac4 structure.Please consult with yci�r H6me Qwners Asso0ation and review yQur deed vsar any restrictions�hlch they apply. In considerstion of the grantirsg of this requested permit,!do hereby agree that I will.,in all respects,perform the yLrprk in accordance with the approved plans,the Florida Building Codes and St.Lpcie County Amendmi�r?ts: The following building permit applicatlons are exempt from ur}dergving a full concurrency review.room additions, accessory structures,swimming pools:fences,walls,signs,screen rooms and accessory use§to. another non-res!Oential,use WARNING TO OWNER;Your NIUre to Recofei fqNotice of tommencem�r>t may ra5eiit Its your€�a�ag lu+ric�for improvements to yct l t�, p .A Notice of Comrtt>'ncerrae�►t t��i:st b� recar�i�d arra pas�od on`he job,5ite before the first inspection, if you#Mand to obtain financing,consult with lender or an attorney before r omrri�ncin wrt�rk or r+ecordir: tour hlotice of C�rrr'rnencement. ets�rjLicet)se MONO ... .. _Signa . erg Jesse •I�gent � STATE OF Fi OWA STATE OF FLORLP,4 COUNTY OF t -�.S.s f ��,.�- 4—��. . � COt.lNTV OF ! ;2 Thefra ging instrument was acknowledged before m@ The forgolog Instrument was 4c1(npwledSeO before.me this � 'day of kt c, 20 by this YO Gley of-A-va � -5 .. �,�'20 �. by i C. {btame o person acknowliQ*1ing (Nwq;of perspr;g _ l t l Feature bf. Pt3ry'l?Ul�ife=•'rt a .. igr�disfratyre R I1pt �l Ilr ry eta. f i 1'ari¢ 9 Per4onolly Known OR Produced identification- Personally Kngwn OR Produced Identification Type©f tdentificattvn Pro .4 ad Type of Identification PrPduead_ �-„- t GENA LORENa957067 eai) 4iNotary PuG tic-$at - •- ST 'RUi�`'Commission#F ,� Notary PublicState ofFtotlOa iomm. — ,r.. err o-o- 1 rrTBlorr 7,' RMAIA '•°;k Comm.Ex0rea fdb 7.2020 REVIEW$ � FRONT ZPNI G $UPFAVISOR PLANS VE(3f-3A-fl hl SEA TVft'R�X � NIANGftQVE QIJtT R 1RMEW I . .REbLV WRVl�U �E11W ItrU 'WA—TE _. - �.""�