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HomeMy WebLinkAboutBuilding Permit Application II All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 03., ( 11 j7Permit Number: I t01J 0003 CotJ rwir Y. 't F L Co Bt 1 0 R. --= 11111111111111111111111111111 Building Permit Application Planning and Development Services - Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 L.--- Phone: /Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: IIIKOP,�G15fD]!`NPRTOVEIUIENTL�O:C«\TIQNE' • . . . , . c 6 Address: CO/3S1,ioF`I' Chi Crc ' Legal Description: Property Tax ID#: 33j`-1 50- 00)4 4 eoo—T5 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: �' FDETAI(t DEQ CRI DTI® OF WORK:':. .q a. . Fr. . � . ., e 6Cemeh 6 p exie A m r� C�6(1 i S , crit itV ut9 b5 vw / -. ste_o- 4,7t /96,,,,r 1 c .- G,,i6-.2ffa4;v0.4 T � . •C© vSTRUCTI®N ilFORM a TIONs,. i. p &,ake Additional work to be performed under this permit—check all that apply: 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:$ ‘U 0 6 Utilities: _Sewer _Septic Building Height: OW ER/LE,. EE° . . .. ... .�.: TCONTRACTQR Name ' ruV C -6117 Name. i (a 1 Ai,; Address: . O, UIF ; Company: ► e,tiro epi • - City: ' I O r' J j c(�, .._ State: �� Address: '-( �l-. . Ls( cil Zip Code; j.L F.x: ,City: `:?P�S/cC� State: Pc Phone No. �i 11 _ Zip Code: J 7 1 cn� .- Fax: E-Mail: �.F C' Era 64-00 h Phone No Q �d / c pS6 Fill in fee simple Title Ho der on next p.ge(if different E-Mail -- St 6 60' c' OF.4.1��' -co "`' from the Owner listed above) State or County License C 1ff/t77 ‘ 1 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I SUPPLEMENg. TA CA.ONSTrvr.6 UCTI®N7 I, FORMAT[® ° ',; 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 commencin: work or recordin: our Notice of Commencement. a_, s, reMIIP Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF 51—LA C�I� COUNTY OF FLORIDA C I -Q___COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged efore me , this day of Scl p ,20 i?by this .. day of 3d A) , 20--17 by -C1,,v,\n Ft.car,e s c$,u‘D ' 1 OR S Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced V;i1 L Produced ) L FL Oetu,U0AMI------_ EattAlWJf (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Commission Noc �� .:..,., ,... &�- ' QtG1, • liG' _ , ---imission No. (Seal)'' <PRY P&p, LLEN VAUGHN ' I- P&p, State of LF `_ uip lorida-Notar .% F ��*_ Y Public ' i.=Brat �� %q;of Fro;. My Commissi .079 .g,; Com .P/opfd t/q REVIEWS FRONT -= Cr„Qpires P if NS VEGETATION SEA TURT 't' M1d��6 0-iv HpV COUNTER REVIEW~ --7"-`-‘"I''''.7.-.. r "["�I �_2 IEW REVIEW REVIEW `--is.,.1,_ 'ss��G 2700'1 �Uer 22P E.p�� i DATE - es RECEIVED DATE COMPLETED ev. 8/2/17