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HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Nd�mber:' Y I I . Building Permit Application :, Planning and Development Services I Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 ; Phone: (772),462-1553 Fax: (772)462-1578 Commercial. Residential _ i PERMIT APPLICATION FOR: PROPOSED i,NPROUEME T LOCATION: FLAddress: 35� Legal Description: „ 5,gva"f-�, 1 " 42— 61 1— Z RoYe-v►l-e M ��(z -/�,� : ,� ,,���, 2( 4 Lam}- i� �( d� (d�- i5� �2 Pr'opertyTax ID#: "I 2— IU &0I Cid 14()C)C)g i' Lot No. Site Plan Name: �1• + Block No. Project Name:' ` Setbacks Front Back: Right Side: Left Side: DETAILED DWS,CR+I'PTION N WORK: l&C,& �kl�-(w'C)Dd CUL-L LA,"- 0'a-fv(O- ec� cQr''S; rep Cck-c-e_ CONS RUCTI • N INFO ; MTION: Additionalworkto a per orme under this permit-check a that appy: _Mechanical _Gas Tank _Gas Piping _Shutters f". '=` 'Windows/Doors Electric _Plumbing =Sprinklers _Generator ;Roof Pitch ' c Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ � Utilities: _Sewer _Septic Building Height: OWNER/LE�S;tiSE: CONTRA OR: Name L hA V VA12-HName: Address: ?J•-:35 V Company:, City:fi0or+ T W—rC-Q_ State: Address"5""` izip Code3Lt'd( �S Fax:/ City: E::.. I State: Phone No. ':?4L+3 lS to Z Z Code: Fax: E-Mail: 1z-,::g_+' W& CDM Phone'No Fill in fee simple Title Holder on next Age(if different E-Mail from the Owner listed above) State or County License Ifivalue of construction is 2500 or more,a RECORDED Notice of Commencement is required. ' SUPPLEMENTAL, IMMIL N LAW INF©RMAT(O 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 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. 4,�"r / , V__ — % Signature of Owner Lessee/ ntractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA� � FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this JLo_day of YYb, t-It,, 201-2 by this day of 20_ by 1 ' (Name of person acknowledging (Name of person acknowledging) (Signature of Notary Public-Sta ) (Signature of Notary Public-State of Florida a of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced FL \Q0—* Produced Commission No.� g'�'�"P'"`"`� "'A Commission No. (Seal) A=Z1 r ..� tar PubUdSItAHNA INGRAM Y.P YqtntP.of Florida mm. Expii es Dec 20,2018 REVIEWS �� 'f^_ - fission' ��i ssion #.WRERUJS PLANS VEGETATION SEA TURTLE MANGROVE '_P&-VIEWoughN tion;REVIE Fn• REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014