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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ' Date: / --1(7-19 Permit Number: / 1 c } 9 ` r ,,,,.s*-wa:,-.:trirwpit4.-&.:_,...... - . ..,...„1/4 Com INT Y F L rJ R 1 Q Fk 4.111111.1.1111111.11.1111111111111111.11111111. 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 w ' PERMIT APPLICATION FOR: 'PROPOSED 0[ PROVEM .LOCATI®Ng: .. ,. . , ,e , Address: -70F Q ,cZ.., n PLC= Z- Legal Description: &u J-V-S SID gL� A 110 S ('. (,1, Property Tax ID#: 34/33 7©( co c 0 otoo C Lot No. Site Plan Name: 2vc L`4?rL, s l Block No. Project Name: Setbacks Front I Back: Right Side: Left Side: iVrAlibt) DEL CRiPTION4 W®°K. `� , 'In i"rvlbt 5 G-V W 6-1., shote 1 1.3._ 12-eor U..3 f_' . ..1_4--137,k-u, ti3 (,t D--sty =w& CQ ST CTION I i 1PORMATION° .:;it.:, . ' , , ...:, . •ten ,®,i , a: . Additional work to be pertormed, under this permit-check all that apply: 1 _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors ' _Electric _Plumbing _Sprinklers • _Generator Roof 2,l 2. Pitch Total Sq. Ft of Construction: 7c770 Sq. Ft. of First Floor: Cost of Construction:$ _ Is-00,6-0 _ Utilities: _Sewer _Septic Building Height: k 51virt..1 �1/LME/ice LE AE: .€®NTRACTORo.. '- Name `>&\.AVtFeVt (,v�4Gly Name: . -- ' _ Address: (o240. Bi u A,4 Z.1C L 'r 1 Company _!_ i___. __ _ .os LL—C- City: pAIAA, L c State:Ft Address:32 7 t OC ,twt - V? Zip Code: 3q 0/0 ' Fax: City: pce State: -&t , Phone No. -1-1,-L, 332. t-'(4, 0 Zip Code: 'F ,,g`2_ Fax: E-Mail: ,✓4 Phone No 7z 7,14r---1(611-f7 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License Cie.GO551W//e24-, 1 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. II I SUPPLEMENT` INS R Cr oN bL�J"J IN,- RMATIa' ''. p --,_� DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: A 41 11 ( orv'U �( (, Name: Address: 66, 1F(,+ri ..vi Address: City: .j ecevze, State: /'(.. City: State: Zip: 31gc-V Phone '-2--)-7_ 4&0 --71,4-1 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 lende • an attorney before commencin wor : ecordin: our Notice of Commencement. 1 , if Ws e � e Signatur"P wn`essee ontractor as Agent for Owner Signature of Contractor License Hol STATE OF FLORIDA J STATE OF FLORIDA COUNTY OF s 1"L(AX (� COUNTY OF S'- LitC,9,-e . The forgoing instrument was cknowledged before me The forgoing instrument was cknowledged before me this,/'f day of c'Ta ., , 201C( by this 14 day of TCM) ,20/ by STS VP,f1 l 4s o 1G.oG j cS R / ( çT \JczT Name of person making statement. Name of person making statement. Personally Known OR Produced Identification i Personally Known OR Produced Identification Type of Identification Type of Identification , Produced LDL Produced FL– D L— .•/ / , , gaea,/,4 .40,,,.. (Signature of ota ,rrlh-11 ,-,111,111 (Signet :_�_�:_.,_ -._ •. ,.r'. o�`wYP'�� ELLEN VAUGHN ""'� l� UB4,� ;1pRY PV6�, ELLEN VAUGHN ,� Commission No. ;Q ,,ip *:State of Flofr" N� otary Public ° 4�:State of Florida-Notary PGssa - Commissib 'Gp 270079 Commis ion . _ ,��,i�;.,r :y, c ommission #GG 270079 . II•olFF�°"` - My Commission Expires =,,,,oF.�° .' My C'oinmission Expires __nriin Oct..- . . REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED 1 Rev. 8/2/17