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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��y Date: 1'' /6- 19 Permit Number: OOP' /9?)(L F L Co R 1 CR A, 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 TYPE: .PRO;©SED�IVPR01EM =NT LOCATIC ,R, . s , ,. ,m �. b Address: g/Oi (9ArG - vF: Property Tax ID#: /30/ _ ea51- ` X52 - jOO —S Lot No. Site Plan Name: A / Block No. Project Name: Za�Le t-7cru /l A – a►•1 am DESCRIPTION o f, ORK° f :°`. . ' 7 :'. 2”7elC y (ces�,;e•C CL. <:/ ,��t4.ieC�� 4 /4/ clic -A e/ec.4.%-J /47z-ye../ / j� .,g / ,P+t / J �/ efyee lrcel (re. ,,,,/e— CONSTRUCT MI INFORMATION. _ :1.7; . . t Additional work to be performed under this permit–check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors lectric _Plumbing _Sprinklers —Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ /8(1O, cc) Utilities: _Sewer Septic Building Height: OW ERA SSE ` "CONTRACT®R°`}' % Name ��//G41 r> 6,'4 .1 al;-7 :„Name: .1��16r/" e/ �c /Ice $ ii'ccsTic Address: '7c l/cAnly.._, .Q,'. Comparr: .`' irc/ce / ... ad;�e.> City: �,�. N/e/CP / State: fe Address: /450 f L,b Pi' -/ r.,,,c Zip Code: 34/ Fax: City: 7-. iNsce State: r-4 Phone No. - 7,09, ;ZjJF-_�,.. ,(f.*t3 / Zip Code:. 3y4)91: Fax: 72d 07,3"0/ 9 :;15. E-Mail: Phone No 77 ' ,3�c -, 09.79 Fill in fee simple Title Holder on next page(if different E-Mail /4/Ivey- eie,ife -/.Se/dlcrc ,1c . from the Owner listed above) State or County License C/3 767/ "4'1, C611' , If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. SUPP-LEM 4 .@ONSTRUCTI©N ...ft [11F® MATI®I : , ' if & :- , .e 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 your Notice of Commencement. ,......Z.---- Signatur f Owner/Les a Contractor as Agent for Owner Signature o Contractor/Lic,/...,,,/ older STATE OF FLORIDA STATE OF FLORIDA r COUNTY OF S r W.Ge COUNTY OF r L-Ccei C , The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this (S day of cl—CL.d ,20 '7 by this kc—day of 3G f ,201 ' by PO r CM PQ a-WA nn I cal IIA ii I�oG f 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 ,''Z.., n C Produced F-( ,-7) C ((iii.. � (Signature of N a ',`,,: - . r (Signature of '.ta �i lic-St I c`+° ,� ° :State of Florida-Notary Public �' ,�;a `'.State of Florida-Notary Public Commission Nd '= Commission #('tcr 1 70079 Commission N.,.�',,,.;,,;,41 Commission #86 079 ,,,, oF�iAa•,,`{ My Commission Expire® -,,„0 ,,,, , • ommission Expires '"inn% October 22, 2022 ', isio October 22, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED _ DATE COMPLETED ev. 9/26/18