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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO E ACCEPTED `�� Date: Permit Number: 4 Building Permit AP, lication Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce Ft 34982 r^ Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, cli k arrow at the end of line PROiPOSED_INIPRCVEIUIENT LOCATION - A, s f n } 5 Address:CACA SQ�et'h"t7 c�c Legal Description: Property Tax ID#: d -(A l?o- Lot No. �s► Site Plan Name: Block No. 'QCV Project Name: � `,„J'�G e, Setbacks Front Back: Right Side: Left Side: DETAILED`DESCRIPTION 30F WORK: Y 4 . P E -3 Y yfv"i CONSTRUCTION3lNFORMATlON dAdditional work to be pertormed Under this permit-check all 3pply: 0HVAC LJ Gas Tank ❑Gas Piping _ Shutters �WindowsJDoors [._ �JSprinklers enerator L�.1 Roof Electric 0 Plumbing Total Sq. Ft of Construction: S Ft.o First Floor: Cost of Construction:$ � Utilities S wer Septic Building Height: OWNER/4.ESSEE CON ACTOR T NameLey:A$ Q k©r scAwar1G- P- •Ac j-c,[ Name: Address:(A01 S,n ie c on Aaa,c-1 Compa y:4.f �x �,� C=ems"' ikA- City: iFort- i n �G� State: FI Addres -i "? �� U j i ci'T (� I` Zip Code: 3 CG'S J I Fax: City: i t 1t `� C,L State:_] �- c� � Phone No.���`�� (' q�7O Zip Co e:_a� I 3 - Fax: `7 L t1 J Zf0 E-Mail: Phone o. 1f Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State o County License: 0- -) C,C." z If value of construction is$2500 or more,a RECORDED Notice of Commen ement is required. S..UPPLEMENTAL GONSTRUCTIDN M, DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name Address: Add' s: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BOND NG COMPANY: ^Not Applicable Name: Name: Address: Addres : City: City: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance o a permit. St.Lucie County makes no representation that is granting a permit will auth rize the permit holder..to.build.the subject structure --- ' which i"s'in conflict with any applicable Home Owners Association rules,byl-ws or and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review y ur deed for any restrictions which may apply. In consideration of the granting of this requested permit,i do hereby agree hat I will,in all respects, perform the work in accordance with the approved plans,the Florida Building Codes and St.L cle County Amendments. The following building permit applications are exempt from undergoing a fu i concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms an accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Comme cement may result in your paying twice for improvements to your property. A Notice of Commencement ust be recorded and posted on the jobsite before the first inspection. if you intend to obtain financing, co suit with lender or an attorney before commencin work or recordin our Notice of Commencement � , 'j?! � s _Signature of Owner/Lessee/Agent azure of Contractor/License Holder STATE OF FLORIDA STATEF FLORI A COUNTY6F � _ COON OF_ � ��c — The for oing instrum nt was acknowledged before me The forg Ing instrument was acknowledge before me this� ay of 20 �$by this ay of�iy 20 by Dai,( _ Q- DaW'� (Na of person acknowledging) (Name of person acknowledging—) (Signatu of No ary Public-St Florida} (Signatur of Nota ublic- ate of Florida) rsonaliy Known OR Produce4 Identifi tion Personail Known OR Produced identification Type of Identification Produced ..Q Type of! entification Prod uc �RYF, ----;rasei vea e ��7.* r�2 ;P n Commissi rn9VoitioO C missi n Na. * .>t * My= SION#FF 951069 P ea!JARRIEL w ce = :April 12,2020 =Commission#FF 968344 4"OF F%Q­ Bonded Thru Budget Notary SerAces ,QRF FSO :w Bonded Thru Troy Fein lnsurance800.385.70% Revised 07/15/2014 " REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS