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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 L� Date: Permit Number:191 �tisp r' � ',tom., ��eas.vr•ai 6,;� 4err. r s � Building Permit Applicata Planning and Development Services n90 Building and Code Regulation Division Co a ,��� 2300 Virginia Avenue,Fort Pierce FL 34982 Vh�}.-`'n` Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED INPROUEMENT LOCATION: Address: 79 I P1406-InA wAM / IT-PIMCA' Fok- Legal Description: Property Tax ID#: ��O I III Ob I 0001� Lot No. Site Plan Name: Block No. Project Name: LO'/7 e!'J14(FICA NgYnJLTD0..1 Setbacks Front Back: Right Side:, Left Side: DETAILED DE�SC tfPTION OF VIIORK: I rzc;rnowr 4- a 4C- 10-AXe, P -1-�.s i�cic,. l�Is�-+� o. e. s li P2r �- 3- 3st�►��z . av l�,� eoo+s' C©'NSTR�UCTI+N UNFORMATI©N: Additional wor to be pertormed under this permit—check all that appy: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator (-Ioof q /� .Pitch Total Sq. Ft of Construction: / • INCt,.WA)7v-- Sq. Ft. of First Floor: Cost of Construction:$ � t�4000 Utilities: =Sewer _Septic Building Height: O NER/ ESS-SE CONTRACTOR: Name Lb Address: $ Company: City: r,=-9'Bg�c State:�,2 'Address'! . Zip Code: _1 Fax: City: = State: Phone No. `�-� -- 2 T,A-' Zip Code: Fax: E-Mail: Si�l�3 Ly k in I af4 Ate_ &V Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License IftOOL C.mF}a- - 11>51 mi aAIJ ywF}o0,Co If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. r DESIGNER/ENGINEER: _­0191ot 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: L,-<ot 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. Signa ur of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDAi - - STATE OF FLORIDA COUNTY OF S /lite- COUNTY OF Thefor oing instru ent was acknowledge before me The forgoing instrument was acknowledged before me this I day of LJLY'-2� 20by this day of 20_ by N % Uuyl Name of pe son making statement. Name of person making statement. Personally Known OR Produced Identification V1 Personally Known OR Produced Identification Type of Identificatio% Type of Identification Produced , Produced (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Commission No. 111111111, KAREN Se IELSEN KAREN(SeaCommission No. (Seal) State of Florida-Notary Public rP Commission*GG 207484 Jurie X12, 022 _ //111111111 REVIEWS R PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED le-Tv. 8/2/17