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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: oC �� • Permit Number: >` 2 d i ! Building Permit Application Planning and Development Services FEB 13 2010 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: -��� PRC}PQSED INaPROVEMENT -0 "A Address: 2 13 W -::l-2 t' SIC- TEL sq!JAD Legal Description: (N tl_'G�tAw C5 SLK. LAT- k2 A>.j\7 V\J � Property Tax ID#: Z' D� �D®� L� D©D Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DEIAII.EE} DESCRIPTIONF WORK z r a 2 t"2- Pt-c.K-E- CONSTRUCTION INFORMATION t 3 h W A vh 5 Additional work to be pe ed under this permit-c ec a that at appy; Mechanical _Gas Tank _Gas Piping ;Shutters _Windows/Doors Electric. _Plumbing _Sprinklers _Generator Roof Pitch Total Sq. Ft of Construction: yCV Sq. Ft.of First Floor: Cost of Construction:$ Utilities: —Sewer —Septic Building Height: l s-mf:�I QUINER/LESSEE. . ; � � >¢ CQNTRACI'QR NametAj g rnA,L �rr,�� �G7� fL I��cL Name: lAt!IX4 Address: g t 3 mss, ?-1 t-t;�, S u Company: c-Lc, City: (;�c frrcrr� Stater Address: 32--z( GLe-' . baz std Zip Code: 3!:L�ty:j!1 Fax: City: 1F--1' State:_ Phone No. `b-77i ob i B[ 5-7 Zip Code: Fax:jj?, 'ib I. -6 k,4 E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. t SUPPLEMENTAL CONSI`RUCTiON LIEN LAW,,INFQ'RNIATIQ^N 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 resultSoraying twice for improvements to your pr rty. A Notice of Commencement must be recor d on the jobsite before the first in pe on. If you intend to obtain financing, consult with I er oney before commencingwo r rec our Notice of Commencement. Signature o Owner Lessee/Contractor as Agent foM:21'65 Signature of Contractor/License Holder STATE OF FLORIDAr STATE OF FLORICOUNTY OF COUNTY OF The f r oing instr ment was acknowledgec{iefore The for oing instru ent was acknowledge,d`�bthis day of 206 bythis r day of 20L o= z (Name of person acknowledging) a;N (Name of person acknowledging) a (Signature of tary Public-State of Floridd) V (Signature of Nlic-State of Florida) Personally Known_ OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te—v–.7/2014