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HomeMy WebLinkAboutbuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: s Building Permit 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 >( I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: Legal Description: Cr Property Tax ID #: qqrl,6- © � 06A - d00 - 4 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front 'Back: Right Side: Left Side: PEL©Cx-rE K lTe4EA9 CUTL.I~T.� k6L0CA"1 T � rkt 6€AA-TOP CMk, O P Oma' t�'Ou li �JP,fi� Dr r w� EP-) DjSP0C-kL-S IA/piSNEP bP-vF2, Abb !'' PEceSS aCfWS, ADD 3 � reN[)E.1,Ji LIGK-FS, Additional work to De oejrrormeo unuerLnt5 pern1[L—GfIC4R dlw cipNly- HVAC L l Gas Tank E]Gas Piping_ Shutters Windows/Doors Electric ® Plumbing Sprinklers 1] Generator O Roof Roof pitch Total Sq. Ft of Construction: Scl.Ft. of First Floor: n Cost of Construction: $ /00o" _ Utilities: Sewer LJ Septic Building Height: Name [,I,ff V, - Address: 'I � �� A City: AUi-1 Ci State: �L Zip Code: 341q c _ Fax: Phone No. 5-61-90J- 13 E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOi':" Name: X71 up, - lr- CL m,iAjrJ Company: A ecoz,mE cikloi l Coli- QAe-2I6, ),Jc Address: 7173 GIA07f'1 Pi - City: f flZ ST Licli- State: FL Zip Code: -305-a Fax: Phone No. ZZL 370- 755 E-Mail:Cciik/ e etzcI is P9(- eovrwav, ( O(I State or County License: 6CW03G?(:P1 if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. tl PLfwN# NT�4L ]fi S # #fC" E UEN LAW fel commencing work or recording our Notice of Commencement DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: _ Name: Address: Address: City: State: Zip: Phone City: State: COUNTY OF 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 iobsite 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 Owner/ Lessee/Contractor as Agent for Owner -�Ilt Signature of C tractor/License Halder STATE OF FLORIDA STATE OF ORIDA /0, COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me this day of The for Ding instru ent w ack owledge�fore me % _ 20� by this day of ,,. p by Name of person making statement a4 �,19f s� rle Name of perso ar aking statement Personally Known OR Produced Identification Personally Known Produced Identification Type of Identification _.QR Type of Identification Produced Produced f (Signature of Notary Public- State of Florida) (Signature of Notary Public- ate of Flo rjdal}rr,�i Commission No. (Seal) Commission No. �`�� REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION � tJl�l� MAIM VE COUNTER REVIEW REVIEW REVIEW REVIEW iO/ DATE RECEIVED •.., . -Q,, �,�� DATE CDMPLETED tev. 8/2/17 FLIN 4 SjAld sligzfz -P;) a uP]d — Ajpumq/AjjLmd/u-aqD - .Zve(j F3(iZ'9bL"195 :w RStEF-H'lajjdnf 4z29,9trL,i9s:4cl Pld umoluetpul AML oilz C) LL .0. L I 3DN3CI15331 3}1244173}124417Aa UFO f 119E EiE ........... no 13 "g -es 0 9d it IZ, II m SIJ F PI it .. .... --------- Wim' Y .... ... ..... Ll it ........... .. --------- . . ......... Yo F it I `J { .............+ ij} ........ ...... ............ ---------- Efl A________—_ 0 WAJ tr. L2 i i a � } 4 t - -E Z7 f[.I� vim. �.�•...-�Y IE'� ti t}� 4 `4 t P ti i i a � } 4 t - -E q;4 Z, i-- z rv) } /