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HomeMy WebLinkAboutBuilding Permit Applicaiton ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: +a—Ng,-lc/ Permit Number: l 'ia- O 3 Fer, :c.--41ekol------,,-,-__:.,„ Building Permit Application 1'Fo Planning and Development Services FC 1 Building and Code Regulation Division pe5 wttin9�e 2018 2300 Virginia Avenue,Fort Pierce FL 34982 t Gticie Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential c°�t PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 1 V-14 cL I LO(oa k br , Legal Description: 3c ocd, C f k Vi\A.S-e_ 1 1-0+ 12 Property Tax ID#: 332_( -5b t - ©Ol 2 - OOO —O Lot No. 11.. Site Plan Name: Block No. Project Name: \--kcL.(Yi�y.,3 rk j �� Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: (4m04.2_ 3 re t c 2 e-0 s'tro r jtoor.5 , S1 2._ Ia r ,S J Ze , r4- Fravti+ 'poor 1 (' x %ill- pC- c.ee AoDr ? Z 95--r" CONSTRUCTION INFORMATION: Additional work to be erformed under this permit—check all tha apply: i El HVAC [1 Gas Tank nGas Piping I _Shutters IX ,Windows/Doors ElElectric ❑ Plumbing `Sprinklers 0 Generator Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ Z VS-a Utilities: _Sewer ElSeptic Building Height: OWNER/LESSEE: , CONTRACTOR: Name & 4 Kease-ik /larr/rbi n Name: (r�S 7 'c 'Cr Address:n1 1 t/ s /-cJ1j/d r,-u-/C br Company: ( IZ .80,161•P-1: C.-0rp City: P 571- LIU f-c- State: FL Address: 3 2._3 I 5 A;GA_ �-ef/' L19 L C 6 Fax: City: -L State: Zip Code: 3 / �' a ,S�`z�� FL. Phone No. ,51f5--- Z37— c/99C Zip Code: 3 I/99 7 Fax: E-Mail: Phone No.772 '7 ( ZS—or-- Fill .,S—or'Fill in fee simple Title Holder on next page(if different E-Mail: (__.I)fc 13Ll, Id erg', L kti from the Owner listed above) ; State or County License J 'L- /3-0 9 7(--/,' S L c-. L3 F63 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: /<Not Applicable MORTGAGE COMPANY: Alot Applicable Name: v Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: )(Not Applicable BONDING COMPANY: lkNot 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 confli ct 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 your Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of ntractor/License Holder STATE OF FLORI i Irl STATE OF FLORID COUNTY OF t I.-�, (o r' COUNTY OF � J /(CC6 The for oing Inst e t as acknowled efore me The mg ins ent as acknowledg ore me this of �� ,20 this ay of ,20 J by Name of person making statement Name of perso making statement Personally Known /1 OR Produced Identification Personally Known I! OR Produced Identification Type of Identification Type of Identification Produced I Produced l' 12.A.L.A_____. / (Sig ature f Nota ' lic-State of Florida) (Signat re of N ary Pu.-c-..tate of Florida) Commission No. 17 '/ZC� (Seal) Commission No. 0)C120 (Seal) REVIEWS FRONT ZONING •ERVISOR PLANS VEGET .T ON_ _SEA TURTLE MANGROVE • VIEW REVIEW REFI �----�-=---= ..-�.11:fiii�� 1,7 R ,, -V ,�1NI --1, IEW DATE ;fi""r'r � My COMMISSION#FF 1794".0 '' Ti. MY COMMISSION 9 FF 179420 +: �` r 2018 =,- EXPIRES:November 25,2018 I RECEIVED ir��i EXPIRES:November 25, r'-:,-A1- � . DATE , .: a ., - • . :,., ,. . ,., f:� COMPLETED Rev.8/2/17