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HomeMy WebLinkAboutUntitled All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: q c> Permit Number: 14931:24 Ca NI 3or F L O R 1 I? .�i ��® Building Permit Application App ®z0rp Planning and Development Services Perrnitti be Build and Code Regulation ivision 1 Viig nia Avenue,Fort Pierce FL 34982 cf 9e C°linrmc'nt 2300 Phone: (772)462-1553 Fax: (772)462-1578 Commercial ) Residential PERMIT APPLICATION FOR: PROPOSEDjNikROYIMIENT,,LOCAFIC7Nt ,�� rRwvo. „ ,d.Qa: if.,q;; f Address: 314 lb —1-1'l4l11,t • Legal Description: Property Tax ID#: 111 -501 r 69t`('6oO 3 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET'AILEID DEQ-SCR�I,PTI®N C)F . gepktit. y® (1/ � , ,o; s i'Llj �, ���� yr 'L -<_y_424-41 CO'NS.TRU.CT1®N , . Additional work to be pertormed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: �° - - Sq. Ft. of First Floor: V Cost of Construction:$ q0•00 Utilities: _Sewer _Septic Building Height: NameittVW4l t-LL Name: k)°ItHvl Z Si Address�:` SDI .p4g,Li 27k S f Company: �( City: J ',( Pc/. State: It. Address: 3,50V J 4 ,1 /�7�`G Zip Code: . 3`t`1t6, Fax: City: 14,P1,_ State/- Phone No. LIWg Zip Code: 375 y7 Fax: La-0,5 f.0 E-Mail: Phone No LIC76"- (96) Fill in fee simple Title Holder on next page(if different E-Mail IAr,`2°Kvtt-(4e- g 401, Ca-, from the Owner listed above) State or County License 1$(5' If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLE ENTAL CONSTRUCTION Mk aq lNf®RMATI©Na .1.4. ° 4,1 ":140-= 7, �$ 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 rec rding your Notice of Commencement. E4:Ls ±7..A__ , Ak Signature of Owner/Lesseb/Contractor as Agent for Owner Signature of Contractor/ cense Holder STATE OF STATE OF FLORIDA COUNTY OF FLORIDAS� - Ck @- COUNTY OF • (.,Lk-CA-F. The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this (0 day of Of<I ,20 ( by this )O day of L1 , 20 (Sr by ---_-‘r-;(_, L_ e— Le_;--1-ot_ur n.ea- & EA- L Le-e_. ( e, - ;-0. (Name of person acknowledging) (Name of person acknowledging) /14\ \ ,p,-- aL. ohm i tore of NotaryPublic-State of Florida ignature of Notary Public-State of Florida g ) ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification -3,— .. z„. .,_ Produced F LI (J Produced -F L--I + (.41'1'7 LP.Jill?HN INGRAM \:\::;„,'.-) iNNotary Public-state ofFlorida ' Commission No. (Seal) Commission No. N1y Com{ �gl;)res Dec 20,2018 (-w s __.: _.__=—^ %;,F-+1���;• Commission F FF 177749 LF • OF FlO,,, s litV`%so LASriAHNA INGRAM T s "",,gym`" Bonded through National Notary Assn. a), 41(x; iduiaiy ri uilu-aiate of Florid, ••, ° •` omm F oirn,n'r 9018 REVIEWS FRON 2„. I omm.SuPFT\T/ F�I 'b�R PLANS VEGETATION SEA TURTLE MANGROVE COUN fY%;,;,,;•.VI��r ed throughlR'�� , vuiaryAssn, EVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ley. 7/2014