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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: lb7N-J 7-/E) Permit Number: I OI ' 0/.3_3 5 iC O L 4 pA .n 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 PERMIT APPLICATION FOR: PRt35a1' �CE ' L �TIC3► rO0PED /1110,411.3 rV "V."4 � t „� Address: Y/3 b, Legal Description: 6-0 G-G( C C.Cel Property Tax ID#: 3 La Lot No. Site Plan Name: Block No. Project Name: Setbacks Front I Back: Right Side: Left Side: I I DTA){ D S-� PT-ION� WORK�§ .Jxerg :v+wa �w 4,M444' h + w. h44k3 � "`�p. ti4.^ t�` �n �1V e Qg-0 C54 1(0— Gc.1vNrc., 4,4' xf Ha n CQN TR a CTLON F®'IMICV, .2 �...° . Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric 1mbing Sprinklers —Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $_La ZUtilities: _Sewer _Septic Building Height: .27_�.... 4"y,�bi©NT'R ORs.v.m� ��. ....:�w av Name 1)2-.aS y Name: fo60^-)- 4PVP6 i Address:.. Y/3 '+t(co6,3- L'& Company: HHvVV (i r p/urk���j City:' 103 L State:F Address:` J Z s ` LA) r q ( r Zip Code: 3 Y5 S"L Fax: City: rS C State: rc, Phone No. 77 2 3 70 f 6 R Zip Code: 35/ c/ Fax: E-Mail: Phone No -7 -2 Z 370 1('7V XiM Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License r-c I 06`7 I S If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. YYr � i� � �T AOI ffi !° .��1"il�k a ��� DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: _ Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie County makes no represu sentation that is granting a permit will authorize the permit holder to build thesubject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all'respects, perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. The following building peyfnit a)$lications are exempt from undergoing a full concurrency re ' : room a itions, accessory structure ,s .• immin pools,fences,walls,signs,screen rooms and accessory tto anoth ? on-residential use WARNING T 10*NER/ our failure to Record a Notice of Commencement, ay sultn your paying twice for improveme •s to'your/property. A Notice of Commencement must be/ec de 'and posted on the jobsite before the irst`i'nsp- tion. If you intend to obtain financing, consult it l� en e'r or an attorney before comment' g,'w.ork •r recording your Notice of Commencement. , / �^ ,j/ / /, Signatyir'e,a Oirer/Less-e/Contractor as Agent for Owner . Si,.tur•'of Contractor/License Holder STATE OF COUNTY OF FLORIDA ` � lC�P COUNTY OF STATE OF FLORIDA �� r �C The folgoing instrum�nt was acknowledged before me The kit-going instru�f, nt was acknowledged before me yday L1 C_ ,20/cby this dayof �C'� ,20 ��b this ] of Name of person making statement. Name of person making statement. ` / Personally Known OR Produced Identification ✓ Perso/ally Known OR Produced Identificatiort� Type of Identi 'catio Type/of Identification Produced )( Produced L ` (Ji /L" l _ / 1t.__� (Signature of Nr,. ry Public-State of Floi i. "'. "': 1 otary Public-State o :.`�. ELt, •-a r o�;'sva� ELLEN V, �' " . ,n�"_State of FI VAUGt k h� ,. �i e6s.State of Florica-Notary.Publicjll 11 Qom; Commis orida-Notary N Commission Nc6 6- a�Ob7 11, &G_� sion . ubli ,I'��t� Commission A�[i�BWB> 7� ��,°;,; -‘al)my #G 9 c,4,..' •My Commission •Expires YOCtobornssionG;2X07 'Imp„' October 22 2022_._ sober 22, 2,21 res - REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW . REVIEW REVIEW DATE RECEIVED DATE - COMPLETED ley. 8/2/17