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HomeMy WebLinkAboutBuilding Permit Application (3) . i All APPLICABLE INFO MUST BE CCfIVIPLETED FOR APPLICATION TO BE ACCEPID • Date: Permit Number: j1 'ti5o 317 _ �-- .. ' COLI NIT 3," F L o R I Q i. MAY 11 701e Building Permit Application perm! ttj�BDe Planning and Development Services St,Lucie C©anent • Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential - PERMIT APPLICATION FOR: PROP®SED.INT LOCATl{+3N • i. ,a ... .,�, =mom _ . rA .� ,.,.. ,,d �..�...i..:„.,÷, �• _ Address: 'R(09)c) 1-kia(� r "P1i\fS ILor a \ Legal Description'. 1,4 i�d�er �ii' es S`�c��.es �l . NLa kZ (,!.on. NC\ Coy 3y12-1—ic17 ) Property Tax ID#: ZZ 23-701' (54- 11- 15-Ob-7. Lot No. q... Site Plan Name: Block No. 'A Project Name: Setbacks Front Back: Right Side: Left Side: • DETAILED DiESCRI'PTI®N t�F, #_ t he t 4, a a b r\r‘,.t- c-y r.:?01is- -Lek 6 en)I\5 �-C ,\c.�c€ 3AI p catA ( ftcc-4 e 11 x (2, pc;;A o . C®NSTRUCTI'®NFORMATIO- No 4 ‘`;' ::-0:-',.,f,' • Additional work to be performed 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: Cost of Construction:$ ( ,lr)Q-Ej Utilities: _Sewer _Septic Building Height: ;®WNER/LEASSEE? 2:::4,;•'. CONTRACTORS-; Name Ect.t.3mq V Ick � 1c ,,3 SV.j Name. [5� Address: -b pt f 68f11�11 �r12_,C1 Company: City: F-t- 4[jt' State:r(, Address: i Zip Code: 3 tk aCtS Fax: City: State: Phone No.-11 Z. LI 66 2(q,4 I^ Zip Code: Fax: E-Mail: 1C�Vl p� t)(V �Qfy ( C y4.rl 60•LoTh Phone No • Fill in fee simple • le HoldeF on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. • • DESIGNER/ENGINEER: __—'~~^'"~r'--- MORTGAGE �='~" -^'~'^ ----'-~'' -, -- Name: — lNarhe; • Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable Name: • Name: Address: Address: Zip: Phone: Zip: Phone: OWNER/�CONTRACTORKAFFIDVIT:Application is hereby made to obtain a permit to do the workand installation as indicated. . I cethat no work or installation has commenced prior to the issuance of a permit. St.Luciakes no representation thatis thermitholder to build the subject ure which is in conflict with any nome Owners Association rules, = . and covenants that...., restrict-r, - - h structure. Pieaseconsu�with your Home Owners Asociadonandrevewyourdeegforanyresnomwhich apply. In consideration of the granting of thirequested permit, I do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,te 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:YmmrfaNmrmtmReumnda Notice of Commencement may result in your paying twice for jobsite /\ N Notice u fCnnencernentrnVstberecordedandpostedonthe improvements to your property. o �on» financing, |t vvith |end�r or an attorney before �2for�t�efir�tiD3pec�io�. |fy�UiDt�ndt� o obtainc�n�u commencing work or recording your Notice of Commencement. 304/../}-t- ' L » -\.n 4'~- =~�^ �-- �� ''' -- .'2_41...1,..- ��� tfnr Owner Signature of[on¢rac1or/UcenseHolder 3i�natureofOxvner/Le�see/Con�ractorasA�en � STATE OF FLORIDASTATE OF FLORIDA COUNTY OF 6 4-^N.A)c-%e. COUNTY OF k | 6 d before me Theforgoing efore me TheforQoin0instrumentwasannowe �e 'u~ ~ & ZO - ��~ �� bythisdayofby th���x day of ��u�� , 20 , ~~ ^ ~ � ^ ' =_^�=a~~���� �ww�� ������ =^L ,.. (Name of person acknowledging) (Name of person acknowledging) �--».-��N,°.,~.t)- --- . (5ignatureofNotary PubUo-State ofF|o�da) (Si�nature�fNo�aryPuU�c'StatemfF|ohda) Persuna|\yKnnvvn OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced ` ARE GIVENS Commission No. -- $(-1...., K� �- Commission No. (Seal) REVIEWS FROM, ^-~-�~~— SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVEMANGROVE" =~COUNTER REVIEW . REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED • ley. 7/2014