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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED B / Date: Permit Number: 1 • ©I' o s to € r ! 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: 1 �d Svc vti Its PRVPasEo IpRovElT� .aclY�cl�. � � � �a n 9 � Address: 11?l AA C�f �il r �i�"/9Td-�I Legal Description:SALr M 9 A44r Property Tax ID#: 7a3 "00 z - 0e99—E Lot No. � a -fid � Site Plan Name: I Block No. I Project Name: Setbacks Front Back: Right Side: Left Side: kaZ a M a_•q 02" Y #L �.� s . �< ICNQNSTCRUTNINQRA # �. _Q.:.. . Additionalwork to be pertormed under this permit—check all that appy: 4 I —Mechanical _Gas Tank —Gas Piping —Shutters` Windows/Doors —Electric —Plumbing _Sprinklers —Generator r/Roof Pitch Total Sq. Ft of Construction: N(1.2 Sq. Ft. of First Floor: i Cost of Construction:$ &L(2o, oo utilities: Sewer —Septic Building Height: Q�NER/LESS E s .. ,ONA QR I �, : Name CQJ�Q� T lNle� �'� Name: -014 J Address: 37,-)`{ Company:tyj,( T City: S� �.1CF � -�� State: AddressaQ 33 IF,l Y'cQ, n Zip Code: 3��.�z Fax: City:-(2;j o O —State: 1 r Phone No. 2a Zip Code: (ax:772—�2KD-yW5-/ E-Mail: Phone No /7 2 — 3 70 —,S-7-8 Fill in fee simple Title Holder on next page(if different E-Maili^/cc /z from the Owner listed above) State or County License i If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I ' I SUPPI�ENIENTAI CC}NSTRUCTIQN t~ {NRLAIN INF©RMATlQIN: °. 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 thepermit 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. Signature of Ow r essee/ rac as Agent for Owner gignature of Con r ctor/License Holde STATE OF FLORID STATE OF FLORIDA COUNTY OF COUNTY OF s • A-u_r A 0,, The for oing instrument was acknowledge before me The foQrgoing instrument was acknowledge before me this�day of 20 by this�O day of ��-J� 20_ by ffA a10 x (Name of person acknowledging) (Name of person acknowledging) (Signat re of Notary ublic-State of Florida) (Signature of Notary Publi -State of Florida) Personally Known OR Produced Identification F4 Personally KnownUF Type of Identification Type of Identification �:�P�3•., DEANNA MARIE GIVENS Produced _L duced L MYCOMPu11SSI0N#GG 022023 oo;Pa'P�s� CARMEN CORINA TEXIER ; EXPIRES:December 16,2020 _ Bonded 7h Public Undewiitem Commission No!D� RMW)Public-State of Flori a mmission No. � zN Commission#FF 926877 Mv Comm.Ex fres Oct 13 2019 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014