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HomeMy WebLinkAboutBuilding Permit Application i it t i I ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACC E PM ! bate: . 112 Permit Number. 030. �"Cl Building Permit Application!; j Planning and DevetopmentServices Building and Cade Reguiatian Division 2300 Virginia Avenue,Fort Fierce FL 34982 Phone:(772)462-3553 Fax:(772)462»1578 Commercial Residential =000c PERMIT APPLICATION FOR*- P � To Select from dro box, click arrow at#lie end of line ' P I V EM-NT 'O - k PRO O5ED NIPRO E L Address: ? 41 /r< e k Legal•Description: Property Tax ID# `/SGS —, �f GQ d �-.—U c'�� -r? II Cot.No. Site Plan Nance: l Block No. Project Name: ' ( Setbacks Front Back PJghtSide:—Left ide: T'I .I R DETAI _© Cly IP vF WO K �s CONSTRuc'nON-INFORMATION: . .• . - -Additionalwor a rme l under is permtt— a app HVIAC ri Gas Tank Deas Piping _Shutters Windows/Doors RIElectric ElPlumbing Sprinklers Generator O hoof I) ITotal Sq.Ft of Construction: .Ft,of First Floor: Cost of Construction:$ ?0" Util'ttier. Sewer Septic' Budding Height: OWIVERII ES.�iEE ; ..Cl?lma4G71?R: F` Name rLr. ,>i Name: JohnRLaw Address: `-! 1 a i S in a d otr Company: Lao's Medilcal SdW=Inc City. t1 v ,-aQ cs State: cLt Address: 51581 Nw R irfi»St! Zip Code: 7 x 7 Fax: City-' PT ST Lune State:FL i Phone No. -7 -7 6,5- x S-7 3 Zip Code: 34863 I' Fax+ E-Mail: Phone No- 7721370 43$7 1i Fill in fee simple Title Holder on next page{if different E-Mail.lohnlauu5958@aoLaom from the Owner listed above) State or County%License-. 29432 I f value afr construction is$75oo or more,a RECORDIM Notice of Commencement is Ij required. L•d -B zL-L99-L9S LKC8L8ZLiMV1 ezc4L LL ZL oaQ i Sf FE?%E-ME T L:Ct7MS C1;Li74 ,CtEN 1 A jtJ!tt'�FCIRiti7j DESIGNERJENGINEER: Not Applicable MORTGAGE et31ViPAl y: Not Applicable dame: Name: I i Address' Address' City: . state.• City; II State: Zip: Phone: Zip: 11 Phone: FEE SIMPLE TrrLE HOLDER: _Nat Applicable BONDING COMPANY-:' ` Not Applicable Nance:, Name: Address: Address. AddrII { Cly City, Zip: Phone: z"rp: ii Phone_ I certify that no work or installation has commenced prior to the issuance of a permit' ; St.Lucie Count�yy makes no representation that is granting a ermlt vrili authorize the pplermit holster to build the subject structure which is in confiJetwith any applicable Home Owners Association rules,bylaws or and Covenants that may restrictor prohibitsuch structure.Please consult with your Home Owners Association and redrew your deed fdr any restrictioris which may apply- !n consideration of the granting ofthis requested permit,i do hereby agree that i will,in all resppcts,perform the work in accordance with the approved plans,the Florida Building Codes and St.Lurie County Amendinents. The follo�wtng building perm applications are exemptfrom undergoing a full concurrency review--room additions, accessory structures,swimming pools,fences,walis,signs,screen rooms and accessory uses to another non-residential use { WARNING TO OWNER:Your failure to Record a Notice of Commencement imay rem4t in your paying twice for improvements your property.A Notice of Commencement must be recorded and Hosted on the jobsite before the first inspection.if you intend to obtain financing,consult with tender'or ari attorney before commending work or recording your Notice of Commencement- II is Signature 00wnerf LesseelAgent Signature of Con ctorJUcerese Holder , i STATE OF FLOR A - STATE OF FLO II 4 COUNTY OF A (1C�P COUNTY OFA The forgoing instrument was acknowledged before me The forgoing instro entwas;acknowiedged before me this _day of , 20 J---•by this ! day of t- : ..20 j by 12 {name fpersanaciacowledging) (mame ersonacknowledging) i I [Signature of rotary Public S o Florida} (Signature of Notary public-State of Florida) Lil;/,L Personally Known Y, OR Produced identification Personally Known 6R Produced Identification — Type of identification Produced Type of ldentifiration Pnaduced cammissiom CommissionNo._ j; (Seat) { aR - ANNE BROWN WALMACH �� - — -COMMISSION# Revised 4 "PIREs Apn7 29,2020 �+�MAVf N#��Cli ficrtieN�p, rsoij"�eoEKFtt�s � REVIEWS FRONT ZONING SUPERVISOR PLAINS VEGETA-nON ,{ SEA GROVE COUNTER REVIEW REVIEW REVIEW REVIEW i REVIEW REVIEW DATE 1' COMPLETE ( i INITIALS II y i 11 • 4 1 1 itZ•d -85Z 6-659-695 Ltr££BLSZLLM'd-i e££:6 6 L 6 Z 6 aaQ