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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ Date: Permit Number: I ��� U���� -.--5:: '. -r*,..._- . ,P Cat o F J as h-= IP �q�,� _ ----- Building Permit Application 04440 ? Planning and Development Services e4ses, Building and Code Regulation Division 4' 2300 Virginia Avenue,Fort Pierce FL 34982 04. Phone: (772)462-1553 Fax: (772)462-1578 Commercial _ Residential PERMIT APPLICATION FOR: PROP®SED ,NPROVEMENT LOCATIONQ :p' ? . °, - ''1 _' Address: Sl o 1 I11 -179 N Z—A S f9vr- (i. I! 7e ce4A At .I,C 3 q 9 9 . Legal.Description: fi o 1k/i /-fie/ J-1 S /I-DPW eLk 1i N 0 LOT / 0 AT i/2• o r to-t- a� oR2 34/4 -7�(07 O Property Tax ID#: /4 3 (" 701 - 0 0 Y/- 0 0 © - g' Lot Noi4 °fA Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D ;] I E-C'R PTI®NC W®RK° : . :� *. ,' - l e`9 R . m,-/ -e.X.`s 04 S1i: k. f ci axe / Go ; ) fit. G, n 5 • , c? ( Th 'o //FR r4G-o) @ONSTR. CT 0 [ IF®RMATI®Nge ,.R'' . .4a t,.a _ .i. as1 . ;a .- ' "! ".:41'.'1 Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters. Windows/Doors Electric —Plumbing —Sprinklers —Generator " of Pitch Total Sq. Ft of Construction: c .7-2 CYO, ' Sq. Ft. of First Floor: lieA6' • .Ia Cost of Construction:$ (/ • Utilities: _Sewer Septic Building Height: OW 1/LEISSEEg t..,' a,C F�' F Dd.' `4rFQ C: � i '1 • •, :'A. . s .o �i M' P n:.e1"5 • s.„,„ C, a, 1.1 —. o- , c. K•� C L � �� • f fRi 0'. Named+iY lc'a�, Name: 0,„ / _t. Addr.ess:..S(a( _ ,t l4.-l3k.Nz S Ave—. C ` RailVditit _ 1;g:'-k--.4115 .:it L L C City: 0-, P;e A CW„ State: ft Address: %I4 so. ' hse.4;•cfd 51 Zip Code: 3 ( 9`f(0 Fax: / City: P f 5+. '-ctc%e_ State:I(• Phone No. C7a)1(-7 - ? 1(W_ 4-.e.--( Zip Code: 4'15 3 Fax: -� E-Mail: a!N�A• ft�5 •/2P.a.1.4(08031114�>< Phone No e77a)a( 2- 5 I kif Fill in fee simple Title Holder on next page( if different E-Mail Roy vi N3. Li0 @ ' 1. C4IWN from the Owner listed above) State or County License C- -C(3 3 (3 a L If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMEiVTAL CONSTRU'C+TION LIEN-[ I FORMATIOQNd 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 a 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 ppermitholder to build the subject structure which is in conflict with any,applicable Home-Owners Association rules,bylaws'orand 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 commenc: : work or recordin our Notice of CommencementAs �/ Ar. / 1� �XA- , /i Signature .f Owner Lessee/Contractor as:Agent for Owner.. Signature• of Contract&/License Holder STATE OF FLORID - - I STATE OF FLORID4 COUNTY OF ,5f, /�c,c. c c'e COUNTY OF i . L"Ct.Ct'e The for,going instrumep pas acknowledged before me The forgoing instrument was acknowledgedbefore me this2 day of A I ,20 / rby this day of IV/97' , 20 la by (Name of person acknowledging) (Name of person acknowledging) „Ai t (411 — (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida ) Personally Known , . , Personally Known VI--.----4• • Type of Identification ArooNiik Noir/Pi*alb IMMO Type of Identification firr Notary Pubic State d Honda Produced • tt�n lk SMI Produced Brandon Smith - MI 1$? c •my Commiuton GG 137433 •a lapws , • 'l' uw� Expras 08/2312021•_ Commission No. , .• •• , • ; Commission No. •. REVIEWS FRONT ZONING , SUPERVISOR PLANS VEGETATION - SEA TURTLE MANGROVE COUNTER •REVIEW ' • REVIEW REVIEW REVIEW ' ' ' REVIEW • - REVIEW DATE .. - . . • . RECEIVED. . . - DATE • COMPLETED' ' - Rev. 7/2014