Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 7_102 Date: Permit Number: f -6� ztl 7 xv 0 w �-'F _ i6. .... Building Permit Application AUG 2 3 2Uw 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: -ti C YL t- ou-1 LGzf_ izi z k PR+OP®SED INPROUEMENT L®CATI'iRQ Address: Legal Description: Property Tax ID#: —3 ZV-5—D )— 19 02-CU(Iq Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET ILED *'E�SCR PTION OAF WO'R+ CLK o of, 01-4)6YAW ASO L(A)--'r— iii-2iii[ 2�_ C®NSITIMI'QQ I IiN!FO'R�M0TI©N: Additional-Workto a performed un er t is permit-c ec a t at app y: O Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 76W _ Utilities: —Sewer —Septic Building Height: r CO�NR O R: O ER LESSEE; .Name /�o '4 Name: J>oje,145 15 Address: 27� /its �,���a. s,�.J ��> Company:&,LGis ��u-c g.,�✓HLcku�.1L City: TGr State: Address: i Zip Code: 3 9.5-3 Fax: �� City: rs; Xaa f it- Stater Phone No.' Z 77� cl,77 7 99 Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail(siGGlS rc from the Owner listed above) State or County License -4-_ 237/3 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. w SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION; 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.L �77 1`1-� N Sig6t,dre of Own r`/Lessee/Contractor s Agent r�dLv-evheg Signature of Contractor/License Holder ?Z I a� mcn STATE OF FLORID =zL a STATE OF FLORI w�W COUNTY OF z COUNTY OF "� rmcn., ,u oC - wsw � ¢rwa The forgoing instrument was acknowledged befor The forgoing instru nt was acknowledged b fore meG this day of 202,by m this day Of 20J y;���;?���: dynn'�l irs (Name of person acknowledging) '�' (Name of person acknowledging—aZJ2 ) (Signature of Ntp Public-State of Florida) (Si�AiNot y ublic-State of Florida) ` Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identif(ca`K' Type of Id i . Ain Produced Produced d —A' Commission No. (Seal) Commission o. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Kev. 7/2014