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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C S� Date: v• 2 1• a` Permit Number: /J IA JA4uno:) apn1 :4S 4uaw4jeda(] 6uP4iWJ@d :a ' - 8102 I ti AN Perm it'Applic tion Planning and Development Services Building and Code Regulation Division U=A J311 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resl ehtial PERMIT APPLICATION FOR: PR�OPQSED I,NFRD�IEME Lt�CAl'It� r Address: 700-7 0 �� ;-e l it .3 9s LAl. Description: �o r � �e u/0 6 G v' V l l Ue . 1 1 Property Tax ID#: O 0:1.09 — o 6 0 -7 Lot No. 1 Site Plan Name: Pl e X ,5 reat Block No. Project Name: Vete( D Pfifl-, ) r,06(e � � z Setbacks Front Back: Right Side: Left Side: 0 ETAILED DE�SCRI-PTION ©F WORK:-17 o S fir u �tjVeuLl - bo c-e es S e C- en' to be " Tall -Vo o Fe (eJ1 3 ' w. 6Ate on &01 S -� % l r a L r :-51 - r {s CONSTRUCT I O% INFORMIT]IOINS • Additional work to, a performed, uridertis permit-check a ,t at.app y: ; 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: Utilities: _Sewer Septic Building.Height: �, r7 O ER/L�S�SEE: CONTRAC C}R: , Name e/ Name: Address: 0- Y,b 14,5 R d Company: / t! Jlr C City: / e State:P11 Address: 1 t Zip Code:312� Fax: City: ar C Stater Phone No. 7 a -S at)y Zip Code: ,7? � J=S L Fax: E-,Mail: p elf l en.n<S comG ,q,S � p Phone No 7 7 L`S (9 ` a-1, Fill in fee simple Title Holder on next page(if different E-Mail 1r1 - -".s T, n eT. from the Owner listed above) State or County License C 2 6 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUP�'LEME'N AL CO'NSTI2UCTIaN L1N LA 1} 'ORMATICIN �� s s 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 recording our Notice of Commencement. Signature of Ow er/L ssee/Contractor as A ent for Owner Si ature of Contra cto r/Li cens Holder STATE OF FLO DA :���*Nor•. STA OF FLORIDA COUNTY OF = COUN F U The forgoing instrument was acknowledged befor rpe The forgoing instrument was acknowledge e rE�"trsc this�day of 20�by a X�a thisyl•1 day of I I/Q/�� 20 �p c a m j �+Ch i z �"er' 2 MRS Name of person making statement. w zLZ Name of person making statement. EF., a Personally Known OR Produced Identific i'-- 9 Personalli4 E2y Known OR Produced IdeType of I ntifi on ,a;N Type of Identifi ti Produced Produced � ' C (Signature of No(Ary Public-State of Florida ) Li (Signature of Notary ublic-State of Florida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.