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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:Tl�� Permit Number: `$O1_ 0-111 • Building Permit Applica On= Planning and Development Services )AN "nBuilding and Code Regulation Division2300 Virginia Avenue, Fort Pierce FL 34982 permittingPhone: (772)462-1553 Fax: (772) 462-1578 Commercial ReseA10 — —__ PERMIT APPLICATION FOR: PROPOSED INPROVEMENT LOCATION: Address: L,-� Legal Description: C-�. a 110 Property Tax ID#: _ -3 2-7 —70 2 V O(0 — Cd 5>? Lot No. 9 Site Plan Name: P© D ?-(11 Block No. Project Name: e v L) Pi , Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric -lumbing _Sprinklers _Generator _ Roof Pitch Total Sq. Ft of ConstructioCnn: Sq. Ft. of First Floor: Cost of Construction: $ �7J Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name /5,4 V,-�/\ 0,9 v Name: - -16-C J-Y 5' pec; Address: 7 9 tS ('0k S I--a✓ Company: -t��✓`✓�l�( 0l�i�5 City: pS State:_ Address: /7L5-5/-, Zip Code: /y S Fax: City: �/ State: FL Phone No. 7? 7CJ //S Zip Code Fax: E-Mail: Phone No '- ' 2 322) Fill in fee simple Title Holder on next page ( if different E-Mail /4i'ru U r p / �c from the Owner listed above) State or County License P--k- 00 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: 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 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 I I' ations are exempt from undergoing a full concurrency review: om additions, accessory structures,swimming ols,fences,walls,signs,screen rooms and accessory uses to ther non-residential use WARNING TO N R: Y ur failure t Record a Notice of Commencement may ul your ng twice for improvement to ur oper . A otice of Commencement must be reco e d pos on the jobsite before the fi t i pec n. If ou "ntend to obtain financing, consult with d 'or an as rney before commenci w k o ecor n our Notice of Commencement. Signatu of wn Lessee ontractor as Agent for Owner Signatu/of a Licse Holder STAT OF FLORIDA STATEORID COU TY OF 'Sk . L-0c'N-Q COLIN S The forgoing instry�Pent was acknowledged before me The�orgoing instrument was acknowledged before me this�6 day of J y� 20 14 by this 0 day of�s� 20_% by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary P lic-State of Florida ) (Signature of Nota ublic-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced L_ C- Produced • «� "»<''% DEANNA MARIE GIVENS DEANNAMARIEGIVENS I MYCOMMISSIP1 ��022023 Commission No. MYCdI$W 110N#GG 022023 Commission No. PIRES: o: EXPIRES:De m 6,2020 o Bonded hru Notary Public Ur20te'S °•" Bonded lhru Notary Public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.