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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: s r 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 __z . PERMIT APPLICATION FOR: D-e)V 0 NI ROPOS D INPt��,1lEME T LOGATI.QN. r p p �'( S 0 U9Vb1;t11N2 14� Jy Address: � � � / 1 Legal Description: 6AAD6i'MIA)IOM e-a t- 50/ D 6NQ0M%/J/ Um bb11#,t wee 0,9, a k 3q 5 e 5 55 66-c- s off"�+Lvc-i Property Tax ID#: `7 '� `00 3� 00� Lot No. Site Plan Name: ' 1 (, Block No. D,v Project Name: I Oji lWUIJ S- Setbacks Front Back: Right Side: Left Side: DETAIL D DEASG�t1�PT{ON DF WORK. CONSTRUC {O,N I�N�F©RMATlON: Additional wor to be pertormed under this permit-Check all tat.appy: f _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _jSprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ 5-o60 '� Utilities: —Sewer Septic Building Height: OWN -i /LE-S CONTRA R NameIJ i. iw> v 'Name: barQL,►ro,$c,ri s /cOO.? �,.S6x9^1DRj� Opt � ISS acAddresCompany: Eh�v c f City: State: f- Addres : ( ► f -err= Zip Code: .3gCi ' Fax: City: AOC6 a66 z cJ I Stater Phone No.')IoZ _ (010.'7 -0,,k g' Zip Code: 33 L 2-Y Fax: E-Mail• Cllr Phone No G JL{'_ b32- ` 869 Fill in fee simple Title Holder on next page-(if different E-Mail +e&I Nc. @ qK�rj-n ' M from the Owner listed above) State or County License � JrZ2 3y If:'value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 1 . u-,1 11111 t1111111111a .TMT 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'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. Inconsideration 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 StJucie 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 Comme ceyQnt. C04& Signature of Owner/Lessee/Contractor a—s-Agent for Owner Signature of Contra r/License Hold STATE-OF FLORIDA--,. STATE OF FLORIDA COUNTY OF ; I • COUNTY OF OC _G The forgoing instrument was acknowled ed before me The forgoing instrument was acknowledged before me this Laday,of f)ae VVr- 2 by this La day of 201_ by Name of person makivg'st�tement. Name of person making statement.. Personally Known OR Produced Identification Personally Known " OR Produced Identification Type of Identification Type of Identification Produced Produced 1Z Q S1 ORES ignat of NotaryPublic- * idl�tjary Public-State of Flori a� a of Notary�PU IiC2 "�i FIpddq public-State of Florida Commission#FF 206852 commission#FF 206852 "Qr " o,.-fly t; a��plres Jun 15,2019 Commission No. L - F;?°,' IQ>Tfl�m.Expires Jun 15,2 1 mmission No.CLQ Bonded through National Notary As n. i °FF"��, `Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE ' COMPLETED ev. 8/2/17