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HomeMy WebLinkAboutBuilding Permit Application Jan 23 18 02:45p First Choice Plumbing 7728797860 p.2 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEDC Date: 1 �-�J , 1 Permit N ber: - d J33 Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Orginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax:(772)462-IS78 Commercial Residential OL PERMIT APPLICATION FOR: 'Y 1 \�X �j � v--_ PROPOSED_IMPROVEMENT LOCATION: Address: L = _; +j Legal Description: ,Q -c- ^� Property Tax I D#: - CSS — -- Lot No. Site Plan Name. Block No. Project Name: Setbacks Front Hack: Right Side: Left Side DETAILED DESCRIPTION OF WORK: JL CONSTRUCTION INFORMATION: Additional work to bertormed under tis permit-check all appy: HVAC Gas TankGas Piping Shutters F]Windows/Doors Electric © Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ 'FSC7 Utilities: Sewer ElS tic Building Height: OWNERf LESSEE: CONTRACTOR: NameC..a 4ze� Name: -tic.. ��.�.•r .c1 Address: La.1c_t_ �[i�aaec,. -'V- l $ Company: •3 ' k S. t� �c.crS City: pos 4SA1 State: fit,, Address: Z Zip Code:_3�-1QS.) Fax: City: State: V- Phone No. Zip Code:-54 IckFax: E-Mail: Phone No. - Fill in fee simple Title Holder on next page(if different E-Mail:T r rwlo.i from the Owner listed above) State or County Lice nse: I If value of construction is$2500 or more,a RECORDED Notice of Commencement is reqi dred. Jan 23 18 02:45p First Choice Plumbing 7728797860 p.3 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Add ress: City: State: City: State: Zip: Phone Zip: hone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: P one: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit o 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 pert ilt holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and co enants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for y restrictions which may apply. In consideration of the granting of this requested permit,I do hereby agree that I will,in li respects,perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County A rendments. The following building permit applications are exempt from undergoing a full concurrent review: room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory u es to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement m y 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 commenci w r recording our Notice of Commencement. Signature O ner/lessee/Contractor as Agent for Owner Signatur f ntra, Polder STATE F FL IDA COU OF FL RIDT COUNTY �I� L-��i-C/c� [�GL(ftC� The forgo- instrum nt was acknowledged before me The for ��Ji}�g instru t was acknowledged fore me this of � 201y by thi "'day of .7 20Y Na a of persov/aking statement Name of per o aking statement Personally nown 11�� OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Pylic-State o Signature of Nota ublic-S �C J � NANCY 'sE LANGF R� . D�7 P N EE LAVGFpRD Commission No a1 co'rMiss�oxrcoz 7, mission No. M1n ssioxNGFOR E-XPMEs:adobe,12,201.o r .oaoha iz zo2o REVIEWS FRONT ZONING SUPERVISOR PLANS fVEGETAI ION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED I Rev.8/2/17