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HomeMy WebLinkAboutBuilding Permit Application ;II All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -��" Date: �7 Permit Number: __ .. .w. Building Permit Application 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 X PERMIT APPLICATION FOR: �PMo% oh PROPOSED INPR©VEI\11E NT L®CATION: Address: Oee4,i .0.-. #212 SBafdn 3"cA , ICL• YV? 17 Legal Description: 1-10/.iO4V OZIt 41 -fi Lvt%C Property Tax ID#: q6,11- 5-01- 02 0/- 000 - Y Lot No. 212 I Site Plan Name: ? G O&J Block No. Project Name: Setbacks Front Back:. Right Side: Left Side: i ;JI D'ET ILED D'E�S@RIPTI'O O � WORdK; le ;,0A ,-A4 e7 Pi A, a�A/ 0 f 517,Z rW IA. g .I 'll CONSTRUCTIkIffl I'NI ION• Additional work to be pertormed under tilis permit-check all that appy: i _Mechanical' _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator. _Roof Total Sq. Ft of Construction: y7 Sq. Ft.of First Floor: .y7 Y Cost of Construction:$ /700.0. Utilities: X Sewer _Septic '� Building Height: I I 011UN�ER/ E�SWEE: C®NTRA NameSOsfah 4-&doraA �7 4 a CC 1%gg W#A' Name: Address: I�'�31 rw, .TinDOrf Ui Company:-e"e City: &,t S7� Lc cie State:FL Address: IZI ,/n1/.S,',1 rSdy o c , I Zip Code: 3 y9-53 Fax: City:­Tenfew �(J�cc��i State:. Phone No. 772- 3`/9- 00V5- Zip Code: Fax: 772-82 21 W E-Mail: Phone No 7"71- 220 - 7715- Fill 715Fill in fee simple Title Holder on next page (if different E-Mail Ca," ; from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I� i S�UFP�LEIVI.ENTAL C*®NSTR:UCTI�®N LIEN LA IN4F®RIMATI'®N: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Nof 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.ma_y 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 reco„pding you_r-Wtice of Commencement. Signature.of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA ' COUNTY OF ��C�� COUNTY OF The g instrumpait was, cknowledg before me The r tnstru_Den was acknowiedg efore me thi ay of 20 Jby this day of 20 y V ' 1 (Name of person acknowledging) (Nam of person acknowledging) (Signature of o ary Public-State of Florida (Signa re of N&y Public-State of Florida ) ersonally Known OR Produced Identification Personally Known OR Produced Identification ITTy e , ;rr ”" �'_-" ype 6TTdpnt7ication Produ�e¢P RYP, p ANGELA M HUFF Produced w Notary Public-Sta e o r oridJ�1) ..ipRY P•% ° �s�., ANGELA M HUFF�c =• •° Commission# FF 23473r * ti�: Notary Public-State ofwf�t�� Com _is! a - _ Commissio b =nl viy a .�:, May 27, G N e * OmmissiO #FF 23 F°;,,. nrdeci thrcun!r National Notuv Assn.) /SOF FIOP° My Comm.Expires Ma 4730 . ough National Notary Ass . REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION 'SEA TURTLE-�=--MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Re—v-.7/2014 Planning&Development Services ASBESTOS N b TICE Building&Code Regulation Division. 2300 Virginia Avenue Fort Pierce,FL._34982 Phone:(772)462-2172 Fax:(772)462-6443 i ,j i Asbestos Notice to Contractor �j October 25, 2017 ADAM SMITH BOBCAT SERVICE INC j ADAM SMITH 661 NE SPENCER ST JENSEN BEACH, FL 34957 ji i i RE: Building Permit Number 1710-0623 It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in a,'c1cordance with state and federal law. If :i Signture i i Date 'i .i i .i i �i 10/25/2017 11:38:50 AM