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Home My WebLink AboutBuilding Permit Application All APPLICABLE INFO MUST-BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:� Building Permit Application Planning and Development Services Building and Code Regulation,Division 2300 Virginia Avenue,Fort Pierce FL 34982 ,O hone: (772);462-1553 Fax: (772)462-1578 Commercial �,�-� Residential PERMIT APPLICATION FOR: t - Address: 3 Lo Q t e r� IP Legal Description: ;I , nn �1h_ �V1 n PiopertyTax.ID#: � OCS' (0�`J '� - � oo Lot No. Site Plan Name: Block No. Project Name I. , Setbacks Front Back: Right Side: Left Side: 7� �f' t�l,�'�Q' 'V 1' e- i itionawor to be performed. under this permit—check all that appy: j - _Mechanical _Gas-Tank . _Gas Piping _Shutters _Windows/Doors i _Electric _Plumbing _Sprinklers _Generator _Roof Pitch i Total Sq. Ft of Construction:. Sq. Ft.of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic Building Height: `j Name �l l i 6`H- ./yl e r r l l Name: Address: �3S 'old 7� Qtsac � Company:A ell ms. lee��c� Z LC P Y� Cit '�-5 6eg.c_`i State:��- Address: 1,2 0 6 �� s4- city:.�I Zip Code: .3 a� (o 0 Fax: ??� �1 -02039 City: 11cr6 br,-, , State: F Phone No.1)0 'a -`�`�9 0 F" Zip Code: 3;Ll 6 z Fax: 99,�--99�--R03`Z ail: G / '�7C Rdiee, rpt�-i Ph EM Q 1one No 9W -`/ oZ©3 '7 Fill in fee simple Title Holder on next page(if different E-Mail 175nc� Y��<�- 0/" from the Owner listed-above) State or County License 0-90 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: Not'Applicable ame: --. ._ .. 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 thepermit 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. Signa e of Owner/Lessee/Contractor as Agent for Owner Signature ontractor/License Holder , STATE OF FLORIDA \ STATE OF FLORIDA � COUNTY OF_ COUNTY OFLV��g The forgoing instphMent was acknowledged before me. The forgoing instRment was acknowledged before'me - thi day of �Q .20_ by this��day of 201 by (Name of persona nowledging) (Name of person knowledging) i ature o Notary Publi State of Florida) Ji re of Notary Public-St a of Florida) Personally Known OR Produced Identification Personally Known ,Produced�ld,,nt'fi "Rtayl '"'� ;� Type of Identification: Type of Identificati = *° � Notary Public-State of Florida Produced ncNAIjNA INGRANi Produced N o a MY Comm;Expires Dec 20, u, 2018. r n 'o'eocF�o��.`` Omnlisslon '�FF 177249 Notary Public State of Florida ''��`` Bonded throw Commission No.- '24 '� lyy Comtseal)res Dec 20,2016 Commission No. g alpl Notary Assn. N,9T commission#FF 177249 �FF`°`' Bonded through National Notary Assn. 1 _ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.