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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEDI I Date: Permit Number: Building Permit. Application . Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 I i. Phone: (772)462-1553 Fax: (772)462-1578 COfTlnlerClal Residential li PERMIT APPLICATION FOR: PROPQSED INPR4UEM�ENT LOCATION: Address: Z A � Legal Description• /'—U G .:( 'V(1.A z e 5a Property Tax ID#: ly� "���7i ��Cnh - ! Lot No Site Plan Name: I I I Block No. 23 I; I , Pr'ject Name: setbacks Front Back: Right Side: Left Side' DETAILEDDE:�SCRL�WT_IaN OF WC1RK; GI vv .T 1 II I 1 CONSTRUCTION 1NFOR+MATf©N: rtional work to be pertormed under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors q � i;•�n�'''�f;._'.ivl f�'•'�l:Yt.����". ui.,. `,�y()jf/ '': (•�1 a ��j1:f.� I ��;:� �.,Electr.{� Plumbing _Sprinklers �': . r}Generator,t„� �;; IROOf Pitch Total'Sq Ft of'Co�nstr'fkb6n /: -1 Sq.'F,t::of First Floors S/t:S:�rl(�)1�1�.{1.ifj �:;''�'Y:rq .l, •r� �`�v' t�..• l'...1 _' ri f1.. . Cbst of Construction:$ ��/ ���7 Utilities: _Sewer _Septic Building Height: ovVNER/LESSEE: CONS RACTOR� ' Nam JwA- Name: ,�S VDI'S Xr G Address: �Z50 Company: City: 'e State:Z Address:27b(� 1 \/e Zip Code:3A Fax: City: , t e i, I Stater .Phone No.:7_;�7-G-12 Zip Code: qol Fax: E-Mail: Phone No 7;7J a7t, G!Q 15 Fill in fee simple Title Holder on next page if different E-Mailc'e .C,oc1kC'l)G n � `� from the Owner listed above) State or County License CL Z7 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 1 S`J•PPLEMENTAL CONSTRIJCI"10 LIN L QUI! IN'FDRMAI"ION; DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: 4 1% 1 A Address: Address: INI City: State: City: I V 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 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 fi t inspection. If you intend to obtain financing, consult with lender or an attorney before comm ci ork or reco ding your Notice 21 Commencement. Si na a Owner/Lessee/Contractor Agent for Owner Si na re o ontrac Licen older STATE OF FLORIDA�I c/ STATE OF FLORI6 COUNTY OF i ',� AK., 2, COUNTY OF 5n .�_C� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me' this b day of___5NA2AC1i, 20ja by this —1 day of 50.AAt20-l[h by (Name of pers n acknowl0� Mlle n1Ul P8 u08 ` (Nameoowle ,,� �/��•,, . Klmder" M.Garwood ??Wgi kenuep:sandx3 : �� `� Commission#GG175422 ZZ�GLl99#uolsslwwoo :� _ '*�•. Expires:January 16 2022 ignature of Notary Public-State df Florida) ""' '" (Signature of Notary Public-'S a e``bf Ffffffl Personally Known V OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced DoOf— Commission No.� (Seal) Commission No.66i(%,rl(M (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED �_ev­. 7/2014