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HomeMy WebLinkAboutBuilding Permit Application { I I � All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,q i Date: ��/0-zd f g Permit Number: No _... _ 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 I Residential I ' PERMIT APPLICATION FOR: 7777777777-77777 PRC Pe b )NRR }VVIR MENLOCATIaIv a, v . �. a Address: `6_72- PEIDgtE 3EN{Y L IVE ,p Rr 57, LUC167 Legal Description: 51fUAAIAIA CLU$ LA-'p' Pff6S /JJ-k(5e i Property Tax ID#: 3"tt 2S' ^?0 S— 0039-- 6d oa +, Lot No. �` Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: i Nis DETAILED DES K{PTtC}" WORK. (Z EMove C--os7-f1vc_ V*A*t& tZc d r^-. ,mwc). P en_xe61/ '. .A =51f t G�L-E 20 PF.. �6-0 F T/ M DCAU IE P2o�U�T C©IVSTRUCTfON 1NFORMATICMN z._ �� . .:�.- Additionalwork to be pertormed under this permit c ec a tat appy: _Mechanical _Ga's Tank.: _Gas Piping _Shutters, Windows/Doors �i2c2o d� _Electric _Plumbing _Sprinklers _Generator Roof Pitch Total Sq. Ft of Construction: '2-P00 !!?g Sq. Ft. of First Floor: Cost of Construction: $ Utilities: _Sewer _Septic j Building Height: aWERt, SSEE: g � CMNI"RACTQRRi. Name V t e JA UCA . Name: .M K(414C _lf.+R K t9Y Address: 32-0 1-6ivG . Company: M2 5V'.S%Ee1 tykfcS _tlG City: PORT ST^ Lve16 State: FL, Address: 13796 &C-Ky 1olki 040_6 Zip Code: 34Q f'2- Fax: City: 0 EU_� ��'ct/I;►° State: Phone No. -772.^3c1-3-- 8r7 `/- Zip Code: 33 `f/� i;'' Fax: 5-6f^7ga- lid E-Mail: Phone No 77 2^ X4,(^7 6 4'7 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License (,zeC6s72-3! C6UfuYf� o If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. ! 5UPPLEII/IENTAL CQNSTRUCl"ION LIEN LAW INFQRMATIQN• �. . _ 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 Count 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. ! " Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/Licens older STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF Me rdrn The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20_ by this 11 day of !T4y►l rf:V ,20t? byMf It -A A(N a of person acknowledging) (Name of pers n acknowle gin ) it (S' na ure of Notary Publi - tate of Florida) Cerson ure f Not Public- ate of Florida) Personally Known OR Produced Identification y KnZA own OR Produced Identification Type of Identification Identification Produced d ORGEVINUEZA Notary Public,State of Florida Commission No. (Seal) Commission No. MINIAssionil FF 938900 My comm.exires Nov.24,2019 1'86RAM lic ;4ate of Flo i a REVIEWS FRONT ZONIN ,VPER 1y§—S' . _xpiPLAN§', �1 ETATION SEATURTLE MANGROVE COUNTER REVIEWi ' ' / ommi,slrREVIEW72 9 VIEW REVIEW REVIEW v DATE 'lilt 10�� Banded RECEIVED DATE COMPLETED ev. 7/2014