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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: l7 Permit Number: 1,711- CIS tI o • RECEWED Building Permit Application Planning and Development Services NOV 2 0 2017 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: a. PROpt75ED IN:RRQVEME T L©CATION. � , A .:: �: e Address: gzGga✓' (�—DV!? 0-r. Legal Description: Property Tax ID#: /� �i���/"� 0®E ooa� Lot No. �i Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: '�� a I ti 2, a ®D//eC��,�i iinG� cock 4-At c l er c-i/�t./i f �0�7� %rte - cc 5/.2 t--�- 341 CONSTRUCTION INFORMATION: IN Additional work to Be performed under this' permit-cneCK all t at appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of-Construction:. _. Sq. Ft. of First Floor: Cost of Construction:$�/{O�®� Utilities: —Sewer _Septic Building Height: t t"WI.ES�E. RD, 1 CONT TOR. F T Q, ; Name f1414".Wr Carne P.eo 'Jwners' fac• Name: A//P�ay�t� e, c C�nfruc�ars��� Address: -�1�/0t/4t:bo �^�'dve _�j�. Company: Je7V-7 ei o4ae► �7`"lio City: Cc e State:LAG Address: !�// Gfa�o�l S Zip Code:�?4e4�z Fax: City: State: Phone No. Zip Code: ;?4�r�/9 Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail c olg from.the Owner listed above) State or County License LcaaOM—al— if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 13,9'1 M, ENTAL CONSTRUCTlQN EN LAW IN aRMATtC}N;a a y „ ., 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. Signatur ' f wner/Lessee/Contractor as Aged t for.Own'�r. Signat C ntract older._ N GJ N STATE OF FLORI u - o N ] ) z�� - STATE OF,FLORIDA N COUNTY OF o�(1/Y • �••� i COUNTY OF �.L cs «— H E» The forgoing instrument was acknowledged b '' The forggoing instru ent wa acknowledged before this day of 0'?/ 20L ! _oa F this 'Way of � �• 2013 by o�¢ m m QeW —r;� Jn *c m• y; a e.00wson acknowledging) =a` E :� (Name of person acknowledging) .. •o; ?o` (Signature of Vary-Public-State of Florid ) (Signature of No Public-State.of Florid ) Personally Known /OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced:- Produced Commission No. . (Seal) Commission No. (Seal) REVIEWS FRONT ZONING, SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW `REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.