Loading...
HomeMy WebLinkAboutMartin Permit AppALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 111-7/11 Permit Number: 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 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT / LOCATION: 11 Address: 11Q�i t) (0\,4l_:Y) h'1 ��� ��rn L.T ?)`i Legal Description: C nc,�22n v111f 8 eArbDw, ,G+G P_ ��� 3- �. Property Tax ID #: y S- ®o� Gi Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: _ Right Side: Left Side: DETAILED DESCRIPTION OF WORK: LA: e_ 7 Kw CONSTRUCTION INFORMATION: Ad"2i iona workto e oer orme un er t is permit — check a appy: HVAC 1 Gas Tank Gas Piping _ Shutters � Windows/Doors ❑ Electric ❑ Plumbing Sprinklers ❑ Generator Roof Roof pitch Total Sq. Ft of Construction: S. of First Floor: Cost of Construction: $ `5 I I O UtilitiestSewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name C Yl Address: 5 NW [,y;�fy),gn m Name: AL44A,44 Company: eAl S Address: ^ 4 JI 5F_Q " City: 01t�PP,a)o e State: Zip Code: 3"1179 Fax: Phone No. _71) `53 Cp_y City:CAI frl L.A'y State: _� Zip Code: qC Fax: Phone No.©`�— S31 AIX E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail: A. r cin') -,01'c fry) State or County License: CAC I T I SN6 IT vawe OT construction is �ZSUU or more, a RECORDED Notice of Commencement is required. 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 your Notice of Commencement. hxw g Atu're of Owe e Less / ntractor as Agent for Owner Si at&6 Contract / cen Ider STATE OF FLORIDpa� COUNTY STATE OF FLORID/& McAr OF COUNTY OF . The forgoing instr ment was acknowledged before me The for oing instru ent was acknowledged before me this � ,,e day of !),,mbed' 20A-1by this -7 day of �w'2.,Y)bf f 20 J by Name of persgn making statement Name of person making statement Personally Known ✓ OR Produced Identification Personally Known y/ OR Produced Identification Type of Identification Type of Identification Produced A�cd o i -Z�� Produced 4A (Signature of Notary (Signature of Notary Public- State f F rida ) Notary Pu lic to of Florida Commission No. NOEIIe Commission No.NotaryPublof Florida NMY�lq +� T Expires 08/dir � 0 21ion 13o6oa oelle +•� My Commi �yssiiion GG 130804 Aja Expires 08/01/2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17