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HomeMy WebLinkAboutBuilding Permit Application 4-6) ,: ______,. • . , • .... i‘ii ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: i 0r X3--1, -- Permit Number: iglio-SCJ/V ....„„,... ,-,-„, -,,,j7-. ,,--,:.„;:_„„ 3 COON -Y.: ' f 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 K PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT:LOCATION ::. . _ _ - - , Address: 9 ,l2 /eNdL:LGc7G2.20 L C/ E7' /9e72/pc- Legal Legal Description:Ih2A97 L-j�'14 7 /�l�tirLam% —1ld ?7 7-.1721- --"L- ' 4/fF:, (et,fa... Ct-SG — l 7[ ,.., Property Tax ID#: 152_7- ? /- 7'7/S Lye,- Lot No: z8 Site Plan Name: nn�� Block No. Project Name: L5' ' , 7 /:: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK . - -12 OPLA4 4E)43T F EZ1 no sI z e, cel a n -e . (i i'i pa-z--0 CONSTRUCTION INFORMATION - Additional work to be performed under this permit-check all tha apply: El HVAC _Gas Tank [—has Piping 1 ShuttersWindows/Doffs-_ 0 Electric ❑ Plumbing 1-1 Sprinklers Generator _Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor: o� Cost of Construction:$ /27„��� Utilities: I _Sewer EiSeptic Building Height: '__OWNER/LESSEE . CONTRACTOR : Name Z. fi24 /, - Name: (.)047/u_ j acvi S )� Address:"/,.. 2 ,.,<< % A-I _4 Company:-A APr & C �€ --! L� . City: I - /'�/&724../,) State:. Address:0(f-bk -let c_-r .. Zip Code:3 �j ` Fax: City:Uj , PA( _Q PE ^&-l- State Phone No. Zip Code:: 4 Fax: E-Mail: Phone No. Sial - '5"5-5--- L{'Ce5----- Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License:C6 C 22-83 l If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. T--'-''Y•' .-Lli--,- -<'-:-:.7::::it-:,:::::::--;-::::- ,:::.!,'Z'f:_? I:T SUPPLEMENTAL CONSTRUCT}ON LEEN LAW INFORMATION 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 represu sentation that is granting a permit will authorize the permit holder to build thesubject 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 commenc.ng work or recording your Notice of Commencement. 40-‘1(4-, aJ lc, `i c ,., gnature of Owner/Lessee/Contractor as Agent for Owner a....--D of Contractor/License Holder STATE OF FLORIDA j' , ) STATE OF FLORIDA f COUNTY OF /`'O-L'v v L�CFL COUNTY OF pC6 J ----- The forgoing instru ent was acknowledgettiefore me The forgoing instr en wa acknowledge fore me this g-jday of /G -06e41 ,20/V by this L day of e c ,2006, by `711 cue4 Q., 6? dc, ' S Name of person makings tement / Name of person king statement Personally Known OR Produced Identification I/ Personally Known OR Produced Identification Type of Identificagon Type of Identification Produced l) L__ Produced t , ' Y CCA-CJOYI,OL9 (Si ature of Notary Public-State of Florida 1 (Signat a of No ary Publi tate of Florida) )g,Ya� ,• •e KarenlfS�.P�Cardona osPRYP-B,c ANGELA YOUNG Commission No. ' ,i, �'$ coMM1591 al4F239521 Commission No. _ „.,a A MY COMMISSION#FF*Mg) ' EXPIRES:September 28.2019 NP a= EXPIRES:April 12.2©30 Fr g 3�J5a tigA• W NW.AARONNOTARY.COM 9lsor p.p. Bonded Thru Budget Notary Services REVIEWS FRONT ; ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER 1 REVIEW REVIEW REVIEW • REVIEW REVIEW REVIEW DATE RECEIVED � DATE : COMPLETED Rev.8/2/17