Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: I�� l• I r , + r .Building Perm it Application Planning and Development Services 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: PROPOSED N ,NY IN LOCA Address: -7e? a1 W) l-74 .5 Legal Description: 4 /-1 Y-..* VAtf� �r2 O C- f ?.O Property Tax lD#: L93 p p p Z 00OP-7 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DE MIDI M R't TION F WOR i A C STRUC I• I.NFO MA ION: Additional work toa per orme under this permit-check a that pp y: _Mechanical Gas Tank Gas"Riping ..-Shutters- _Windows/'Doors­' Electric _Plumbing _Sprinklers Generator _Roof Pitch Ti tal Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: _S(wer _Septic Building Height: ORR R WIL&,aE• CONT A OR+, Name ��2v � /1 G ,�L✓�`r.��••,,�� Name: L 72�c-Xtox? 4616-A-1a z- Address: /0/7 ,S�v /L/�-f�7��zL�� Compa y: T-?1, '7l-5 LLC City: /Lc,eg-C-- State: Address: /r/u/ Zip Code: .3� CJ-7r.3 Fax: City: 7-1-C'cle State:- 4-Phone No. = 7.7Z�•2L&, Zdd5�,6 Zip Cod 3 4�( Fax: i - E-Mail: Phone No -,772- Z-Z-Q cl//4�2 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State o County License G GG /S 191--r-aj� If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CaN 101" ISN UE LAW INF©RMATI©N: 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. Si '�a�ture of�Ownerft'es—SW/c7ont6ctor as Agent for Owner tignature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF E-A".A�� COUNTY OFt;ln� The forgoing insent was acknowledged before me The forgoing instru nt was acknowledged before me this day ofm266 by this�day of 20j_ by DX�A" mg.� n"." (Name of person acknowledging) (Name of person acknowledging) ) (SikdatJe of Notary Public-State of Florida) (Signa u of Notary Public-StatA4f Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced ,��ni A� LASHAliNA INGRAM ltv"'�"'"`"` LA5HA4tJA lY" . Commission No. =i°, `�, No(5e41Commission N .�"`r�� (Sl�1 )blic-State of Florida `21-.�#��; Not Public State of lorida 2' My Comm.Expires Dec 20,2018 = tr 4A _.* ,•=My Comm.Expires Dec 20,2018 Cnmmiqqi�n �;:. omm ;t ff i"IL- Bonded i i Bonded thro gh National Notar ,Ass . B n r p I No ar REVIEWS FRO 1?E PLANS V El`A� f���� ° t 3 SS ROVE COUNTER REVIEW REVIEW REVIEW E E REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te—V. 7/2014