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HomeMy WebLinkAboutBuilding Permit Application .All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �/� 5� Permit Number: 09 RECE'rvE® yam. ryr, TI { • o ` a Building Permit Applic tion Nov 3,o 2ot$ Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue,Fort Pierce FL 34982 St, Lucie nty, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial R PERMIT APPLICATION FOR: MSMSE"Dol 1NP ©DEMENT LOCATI®N: Address: 57,08 Pcc. m 6r" I4 A erc.e !"C Legal Description: Property Tax ID#: 3 V0J- 60 -03 66 -UOd 0 Lot No. 1 2- Site Site Plan Name: Block No. 50 Project Name: Setbacks Front ✓ Back: Right Side: Left Side: D TAILED DEASCRIPTION OF VIIORK: CC*ONSTR+UCTIt+� 1NF0 MA IQN: Additional work to be pe orme ; under this permit--check all that appy:. _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ Utilities: —Sewer —Septic Building Height: SEEM, EER/LER&ff CONTRAIrTOR: Name bPsK M ef�ln�sc�ttl Name: ss,nt Address: 6.�Oi) PaIPK br Company: A-I&A Ciarati,,_ r)oor- City: Ft Qr erre- i FL State: FL Address: -V96q- AJUJ-A] - 44e ce b /3(ucl Zip Code: 3 Y q Z, Fax: City: State: F� Phone No. Zip Code: 3`!q q Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail A4ech C C49e noc); d�2 from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONS`"TRU�TtON LIEN l.AW 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 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. 91 Signature of Owner/Lessee/Contractor as Age r Signature of Contractor/License Holder cc w STATE OF FLORI W d STATE OF Dt2* s`, COUNTY OF z COUNTY OF"I ME =o a - r w�wz The orgoing instrument was acknowledged be r� R The fg�jrgoing instrument w s acknowledged of© ✓ rgrLu z thi day of IIY �' 20_J b ¢L'L this (9•day of I�/�y • 20 6 ¢ W o a Name of person making statement. Name of person making statement. =� Personally Known OR Produced Identif ' y Personally Known. OR Produced Identi -.moo.....• . Type of Identification Type of Identification Produced Produced zld" • �� (Signature Notary Public-State of Florida) (Signature of Nota Public-State of Florida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7