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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 n� Date: •� 3• —? Permit Number: / / o? ^ (]y Y , Law=; . - Building Permit ApplicatRFCC- ® Planning and Development Services O g Building and Code Regulation Division SEP i Ed '! 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSE© INPR(31/EMENT L`®CATON: art .. ,�. _ Address: ("/2®S'�o !/ Off' Legal Description: Property Tax ID#: 3 4 1 5_(4 E— V DO — cif " 600 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�SCRFIPTI®NOF 1NRKyh `f p� s i �# 01"N � 1'(', 1 .'F C,®,NS1TR,l1�C�TION INF®RMATI®N.: 2t 0 w Kai 1.. i.' - s s a Additional work to be performed under this permit-check all.tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Y_Electric _Plumbing _Sprinklers _Generator =Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ I, U • d� Utilities: —Sewer —Septic Building Height: ape,r *> b ®WNaER/LESSEE: Name Name Address: °72S- -re-- Company: = `crvlQ City: S< < State:/ Address: //1 �5�,.�Gl� Zip Code: 993 Fax: City: AS-1/-, Stater Phone No Z '5 31 Zip Coder 95"�Y-3 Fax: E-Mail: Phone No ��2 2 Fill in fee simple Title Holder on next page( if different E-Mail 1'GL Gil' ® 69, e 6vv t from the Owner listed above) State r County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLE ENl' L C®NSTR+UC«TI®N l.l!EN 1 ,4W INF®RM/�Tr 4 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: OWNER/CONTRACTOR AFFIDVIT: Application is hereby!m'ade 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/Lese Co or as Agent for Owner Signature of ontract / is a Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF CET-�r_ Liu cbe COUNTY OF ucec The forgoing instrui533ent was ac}c nowledge before me The for oing instru t s ckn wledge before me this day of SC�7` 5f .201 -by this U day of 4 20 I by cLsk ff"Au IN(11D (Name of person ack wle ging) (Name of person ac n wl dging) (Signature of Nota P b F r' (Signature of Notary Pu tate of Florida ) "'oa"Y",",, JOSE FRESNILLO Personal) Known °`P0. `� yroa�rd'idiffmti�tetti$filorida Personally Known .•",1;1` Flroduced tt�fiiSfiF�tdltlr0 Type of Identificatio '_•u n•= Commission#FF 184850 Type of Identification, =_°. ` Notary Public-State of Florida Produced =N•9; a My Comm.Expires Dec 22,2018 produced Commission#FF 184850 �''•������•` Bondedt roughNatlonalNotaryAssn. v Comm.Expires Dec 22,'2018 Commission No. Seal) Commission No. edthrr�fM qonal Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 712-014