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HomeMy WebLinkAboutBuilding Permit Application � I I I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit NumberJl • b133 I 1l � ' - Building Permit Ap Ilicai,l, on Planning and Development Services Building and Code Regulation Division I' i 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential — I': I PERMIT APPLICATION FOR: j I PROPOSED IN!R C}VEM'ENT LOCA I N -. . .. _ . ,ryy�� II, Address: `D Legal Description: �r1Q. /y — d1i Ili XD Q `� Property Tax ID#: Ef.3a"_XD6 I ll Lot.No. Site Plan Name: I! Block No. i Project Name: Setbacks Front Back: Right Side: Left Side: I�I I;; I DETAILED DESG FPTI®N O'F WORK. Q0 F �Ir"n, I II C®NSTRU I ,N INF©R11/IATI®N: t popptNork to be pertormeff under this permit—check all fi at app sF i--M#chapical —Gas Tank _Gas Piping s°~` S.M'utters ` Windows/Doors ' '.Electric Plumbing —Sprinklers ; '�` Qenerator RoofNL Pitch , Total Sq:,.Ftof,Construction: Sq. Ft.of-First Floor: Cost of Construction:$ 1 bo •s 00 Utilities: Sewer-.. Septic Building Height: i d: t I I OW�NE� s�l� : cONTR c�TOR NarieM "; V V Name Address: ` Co`mpany� i iANDFtOS RAOFING �_ I City: �� StateX Address:" -' �-�������Aup Zip Code: (G Fax: City: Ft. Pierce, FL 34947State: Phone No. U77D, Zip Code: f Fax: E-Mail: Phone No 1 ' I Fill in fee simple Title Holder on next page(if different E-Mail I .Y' 'i i Al - from the Owner listed above) State or County License "'O-. f(q C S If,value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I'? L . t St1 _19M 1.GONS �"R CTIt.3N Ltd N Ei FUR+1\!IA`fl`C? 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: 11 A Name: Address: tQL Address: WIR 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 our property. A Notice of Commencement must be rec- ded and posted on the jobsite before the first i pection. If you intend to obtain financing, consult wit nder or an a -torney before comm the w k or a ordin amour Notice of Commencement/. 7gnate 0 ner/ 'see/ on ract r as Agent forOwne 7STE of o tracto /Licen e . erOF FLORIDA" F FLORIDA COUNTY OF v Q_ COUNTY OF The , rgoing instruXMbprN acknowledgld before me The oing instru{ nt was a knowledged efore me this day of 20 by this day of V 20' by (\� 794CIZISVONO NO W CJ l �Y+1S NO (Name o person acknowledging) ', (Name of person acknowledging) a_ vv 0 Z N (Sign re of Notary Public-State of Florida) 'v ` Sig ture of Notary Public-State of Florida) Personally Known c OR Produced Ident ficat rti' �: Personally Known OR Produced Identifica i()_n Type of Identification " "-' Type of Identification o 6 = Produced �i o o °, Produced N ikm -^ m ,n ow o Commission No; ' 'f .'s•' Sea w a Commission No'` (Seal) " d REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7 4