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HomeMy WebLinkAboutBuilding Permit Application Hou 13 2817 13:22:13 Via Fax -> Nonage I _ Page 803 Of 084 All APPLICABLE Wo MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEb � Date: Permit�Surnbe:: �..� - Building Permit �icl Planrytng and Development Services Building and Cade, Regulation Division I 2,300 Virginia Avcnue,Fort Pierce FL 34982 ! , Phone: (772)462-1553 Fax:(772)462-1578 Commercial Resid nti4i � 1 PERMIT APPLICATION FOR. ,� �� AC a Address: rn- ,. L'V(1 Legal Description: � � > � J.m„ �`r� � � � "" lAc , i Property Tax ID It: � Lot No.-,- Srte Plan Narne .,..W _ ...___�...., - � Block o. Project Marne: - Setbacks Front_ _-_ Back: _ Right Side: Left Side: , _ r a I 4 y rtra��r�a vvor o e pe orme un er t rs permrt�c zc�t a gat app y: i ' �IVlecharricai �,Gas Tang ,�Gas Piping .Shutters �_ 1Nindows/Doors I Electric ^Plumbing _Sprinklers �.Generator I hoot Total Scl,Ft of Construction: _ -_ Sq.Ft.of First Floor: I _ Cost:af C6rrstru tion:$ Utilities; Sewer Se tic tBuildiri Height: Name �'lE^ � _ Name; J C. YN:�, f Jnr A+ clress: CA05—_�, f' � = Company:_ .� 2�4- � ? � v1 City: '" '� _ t # .__._......State: Address: is Zip Code:-•�ax ` Fax;, City: .� ,g i _ State.BL._ Phone No.3LI.5� L— Ac Zip code: 3_D'5`t Fax. E-Mail:_ 0;� _ Phone Na '7v - 7• Fill in fee simple Title molder on next page(if different E-Mail .t.c'��✓ � from the Owner.listed above) State or Coun y License . G rF,sate of construction 3:s 2500 or more,a RECORDED Notice of cors mencemertt is required, E i r Hou 13 2817 13:23:44 Via Fax —> VonagePage 884 Of 884 [)E"SIGNER IIilEER: Nod Applicable MORTGAGE COMPANY-, ! of Applicable Name Name: _. _ Address:_ Address: City:. _..................,...�,. tate. City: State: �. Zip: _.. Phoney. __. ,,,,._. ZIP �m.,..,.....T. P hone: ,ice,,,,,,„,,, �.. . . ............ .. _. : .._,....,. ........... ..................... � ...,..,. FEE 5-IMPLE TITLE HOI.DER: LZNot Applicable BONDING COMPANY. _ZKot Applicable Name: _ Name: Address: Address: — ~--. _. ..................— C it Y• ,,, _ _ City:-- I Zip: Phone: Zip:_.��.��....Phone:_- I _....... —.....-........ — __--��u _... .�,. ..—......... OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work anti installation as indicated. I certify that no work or installation lias commenced prior to the issuance of(3 permit. ' St.Lucie County makes no representation that is grontin.g a permit will authorize the hermit holder to build the subject strgcture which is in conflict with any applicable Horne Owners Association rules,iaylaws or unci coV'eriants that may,restrict or prohibit sucl•i strur~turrv.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, Ido hereby agree that f 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 erre exernpt from undcergoln.g a full concurre icy review:room taddltians, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessrxry uses to anflther narl-residential use WARNING TO OWNER.Your failure to Record a notice of Commencement may resultih 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,conskiIt with lender car an attorney before commenein wort reeor 'e'ig your Notice of Commencement. i S r w ,r/Lessee/Agent 5i r r o r¢Tactor/Licens,6 Holder — I E 0F FL A T OF FLORIUNTY i The forgoing instrur tE'nt was cknowledged before:rite: The for Ding Instru .int.was�c knowlt?dgPd before me. this_ ,day of ,20by this�day of � ,2417 by ' I (Name of parson acknowledging) (NdYTte of person acknowled iig) U��� � '���� letlirialPlrT�r i nature of Notary Pub}}ic-State o1 P ”"«° �� (5ignaCure� f ry p kali i e f Flrarea) «"S �� RINA L. lit ACK �ory : 1lv� �+ J u.� Personally known OR PrAc�f�eJ�ntifrcatiowi :�� Personalty Known. QRlProducecjteT�tificab�xn� Tyi)e of identification 2tl�ad� �� :� Type 4f id.�.,,.ntiiication Produced 9�T ' �(p16y { —......_.._�'��,d���4 rq�/°�[Cp�"°AF�FCP'r°sU°st.113•�°��O mProduced ±dCoetha4�—..... ?p A fio Commission Nf- 9 ` Commission V©o. " E.( ° J 1df�pi6li �4 A� REVIEWS FRONT ZONING SUPERVISOR PLATS VEGETATION !SEA TURTLE. MANGROVE COUNTER ItCVIEW REVIEW REVIEW 'REVIEW I� REVIEW REVIEW DATE . _......... .......... — RECEIVED r ........ _..........�.. DATE ... ....... COMPLETEf� r__.....,...,,,�. ............ _._;,_...:.........�..._.. _ _�,._... ......._ J i _._........... _„w,.,..,,,..w �,,, wk.w,,,,, n.......,,_�_...._...... ................_ .....,.Y .,. ...... ... . ............................... I