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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: OMI -_ Building Permit ApplicaVJRIEC EI�E DS rt. Planning and Development Services Building and Code Regulation Division APR ' 9 20182300 Virginia Avenue, Fort Pierce FL 34982 !Phone: (772)462-1553. Fax: (772)462-1578 COfT mercial Retl�g department e��ant r FL PERMIT APPLICATION FOR: -e- PROPOSE© INPR©VEMENT LOCATION: Address: J] ��s S'a-��r^^�-►u �� 1:�4-: Pte,/ p FL 3Y2,52 Legal Description: Property Tax ID#: 3 0 i (o J2. O 0.2 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: C 1-NSTRUCT1+'N INFORIUTATION: Additional work to be pertormed under this permit-check all that appy: Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq:Ft of Construction:. Sq. Ft.of First Floor: Cost of Construction:$ 2f `750 Utilities: —Sewer _Septic Building Height: OWNER/LE�S�SEE: RNTR OR: Name C1t-is-/7na F/ n, rl Name: 19MAJ)i,E A/eG.> Address: -7105' SE lev-mv P-J-- Company: IWO COMS�71VC6 4 City: _ �-_ �t"E.+' State: Address_: -71'9q 6'6V Qt6&A1 9Y2 Zip Code: 3ggS'1 Fax: City: State: Phone No. -7?Z.. 6-52' 007 Zip Code: 3-Vgj0 Fax: E-Mail:-raor-,t5 0 01E-0 f; c o rl�l Phone No 779- 2-20 - /('Ls Fill in fee simple Title Holder on next page( if different E-MailJe-iq n r'e n ✓!i from the Owner listed above) State or County License_ I✓ 6 G 0 J 5713 5 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Sl7P'PLEMEMl"AL R,Of ttJ'�Tta'N LI M LAW IIN4 OftIVIA1"I®' . DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name Address: Address: City: State: City: State: P.hone:' , 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 recordingyour Notice of Commencement. od Sigrfakre of Owner/Lessee/Contractor as Agent for bras Signature of Contractor/License Holder �Zmn'. wno STATE OF FLORIDA A m STATE OF FLORIDA_ cd COUNTY OF i'„ w COUNTY OF =z� �X >DO c The f29 o oing instr ent was acknowledgedbefore m �-' o The for oing instru�rr�nt was acknowledged befor WCC Z this day oft l/ A7 ,L 20 I by „m this day of G�jb rrt 20S-by oX "' (Name of person acknowledging) (Name of person acknowledging) . P 6" (Signature of No ry Public-State of Florida ) (Signature of Nod_ary Public-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 ev. 72 0 14