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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / �/ Date: T / !� 'J Permit Number: 0 1 a RECEIVE® -�r Building Permit Application APR 16 2018 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue,Fort Pierce FL 34981 t. L Cie U nty, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial R PERMIT APPLICATION FOR: PROPOSED tNPROVEMENmj]l[@ IO. : r Address: -19151 b ISOsRood , k uerca E 3-4951 Legal Description: LAY-4--�WCOD U-141-1 LOT 16 C AW PropertyTax ID#: 3y) IDoS, 0161(Q Qm– Lot No. Site Plan Name: 1 _ " • Block No. 1-{� Project Name: LI,�C�k CWS-rt "U��� �7t3S� �' �eS1C��CJ! �y�av0.-ho'n Setbacks Front Back: Right Side: Left Side: DETAILED DE:�SCRI`PTION ©F WORK: e bvi o_xc_1 laa Y o 06 v LQ CONSTRUCTI®N INFORMANI ION: Additional work to be performed under this permit–check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator oof Pitch Total Sq. Ft of Construction: 33 1) Sq. Ft. of First Floor: IsZJ-P Cost of Construction:$ 'Ir g3 Utilities: —Sewer —Septic Building Height: SEEM NiER/LE_&SSSEE: CONTRA� OR: Name KQS1 , Name: Y?1a_kL a - Address: lgC_ 1101. 'ems , (.Company: Ye-GISwle` VLM' b City:- f� `even State: Address:-'I01to l l� .�J i.i -ry`c�r� 5}r _+ Zip Code: 3 1 Fax: City: �t7Y-F �-- Zi. w State: Phone No. �'(�i2 U1Z —AZD i Zip Code: �5'4494 Fax:, , E-Mail: Phone No �'t't2�3'it�- q'►P]O Fill in fee simple Title Holder on next page(if different E-Mail Yoo Ilea=�l-Cr/YeL. from the Owner listed above) State or County License Cil '-,DLO D_-3 Evalue of construction is 2500 or more,a RECORDED Notice of Commencement is required. r SU`PPLEMENl"AL COE�iSTf +UCTI©N LIEN LAW lNI FORMATION: 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 wor or recording our Notice of Commencement. Signature of Owner/Less ee/Contrac r as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID! STATE OF FLORIDA 5? COUNTY OF �-�i- COUNTY OF oc`r ' Q)JQ The�g^rgoing instrum nt was acknowledged before me The fo going instrument was acknowledged before me this ir day of f i 1 20�8by this f� day of .-A PPrll20 6C by A6Lt Lr-)QJA (Name of person acknowl ging) (Name f person acknowledging (Signatule of Notary P�ublic-Sto of Florida) (Sig atur of Notary Public�-State of FloridaPersonally KnownProduced Identification Personally Known � OR Produced Identification Type of Identification Type of Identification Produced I(RISTINA DAVIS roduced KRII TINA E'DAVIS ` = COMMISSION#FF96083:41 Commission No. �2 `c M9ae��7AMISSION#FFgF,083 ommission No. JJ XPIRES March 08-2020 Poch• EXPIFa��@��rch 08.2020 '�„a;;1�`, aurvwti,can r rlafwaNan Bervlw.cw� A071388A'US rtarMNNwe'Y•_ {.�C7�399•Uv3 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /2014