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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ? Date: 3 4 `-W Permit Number:l 03• <<"].� 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)4624578 Commercial Residential PERMIT APPLICATION FOR: PRQPfJSED IIPROVEMENTLOCATIC►N 00 ; Address: "7 �� /� S OCE'ya Legal Description: r Pr,�operty Tax ID 333.1 001 •NOT i' Lot No. Site Plan Name: i,. Block No. Project Name: Setbacks Front Back: Right Side: Left Side: I- DETAILED DESCRIPTION aF VU4RK `,mss roc S1-)-u (77ca s ©/--r CONSTRUCTION INFORMAl'iQN ; T „ lAdclitinn;;l work to be peiformed under this permit—c ec all that appy _Mechanical = Gas Tank- Gas Piping _Shutters Windows/Doors Electric _Plumbing _Sprinklers _Generator w _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ aDoo Utilities: _Sewer —Septic Building Height: r CIEVtitNER/LESSEE d CONTRACTOR ,.. . Name r_nlayl(l 6AC-lq-(3ar�-Sr— Name: y2/ C_ y Address:CI yl z y S' G Cl;/.l-H 54,&V Company: r! �' GZ iGl� r City: 5-r— 4ZLC4 ry Le State: "'Address: F0 %S7 �G ���- rrh Zip Code: Fax: City: State: Phone'No. ��)�2 2`zv Zip Code:.-3 t0=10 , Fax: E-Mail: Phone No "Z �-y,3 1 �-Z 2 2 " Fill in fee simple Title Holder on next page(if different E-Mail F7 ,y1 40.wr_ 6 /� o from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CaNSTRUCTION l:IEN LAW dNFORMAT',' 10N. / pp MORTGAGE COMPANY: _ DESIGNER ENGINEER: _ Not A licable 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 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/License Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF + ,-n ) COUNTY OF The forgoing instrument was acknowledged before me The f rgoing instr ent as acknowledg before me this day of 20� by this day of 2010 by (Name of person acknowledging)11*'P))4nhyJhr), (Name o erson acknowledging) j4r, , aNotary Public-State o lorida) (S' at a of Notary Public-Sta of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. SeaI�ASHAHNAINGRAM C mission No. (522�)tNGRAM AS. Notary Public State of FloridaFlor da �} 0�`tiNi a, Not Public State of Florida rp�nac 20 2118 ?'r°n k�°'s xnlres Dec 20.2016 "oma: CoI Imissio, FF 1772 9 " 4 ' 1 FF 17724 REVIEWS FRONT rr ERV.•ISORry Ass N+ Commission t `Uonded' <P„ NS VEGETATP�.� AB�41� 1TFu9h atIVIi4PVC�f COUNTEf,..t:.R_�/I;EW- - �-'RE•VIEW_—":`" EVIEW REVIEW_ EVt '`REVI DATE RECEIVED DATE COMPLETED ev.