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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPL ABLE INO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: z� . � 1 Ci Permit Number: 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 Vz PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ISR©I C15ED`IMPROVtM,'ENT`-L0CATI0N: Address: l ?.5 -PL-- Legal Description: L&Y" tE-,5 N -V VCA, L-� =2 - Property Tax ID #: � `� —!5-01 — 01 1 - coo -J Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: a_C,2_ 5_0 C� &tA_,C> q,J itis ex>te_-v H-e�,e,v CONSTRUCTION INFORMATION: ACIClitional work to be nertormed under this permit —check all appy: HVAC Gas Tank ❑Gas Piping_ Shutters Windows/Doors FlElectric Plumbing []Sprinklers u Generator FIRoof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ J 2'_J -7 a T S Ft. of First Floor: L_ Utilities. SewerI]Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 1:��J 14A la. Name: W(LTiu, Address:_= QZ Qr je }moi.) 4 ]P` City: Fb i( i— c,) -If- Lou C, State: �P-- Address: 15-31 SF_ Sc- L� Zip Code: L1q ;3'Fax: City: 5 -ti ,JC.._k ` — Phone No. '5 (0 1— 2 -SI — k2 'Z>Z)(�' Zip Code34- ?- Fax: E -Mail: Phone No. 1'"t3-_-3;- 7— Fill in fee simple Tithe Holder on next page (if different E -Mail: 1 n-(�-) C I A e --o-&' from the Owner listed above) State or County License: 14' *� ,S/q 3S If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 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 1 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 wqfk or recording our Notice of Commencement y Y a,..,.'ie°"2'?FZf✓ h art..«: .. "t :.. ted DESIGN ER/EiVGJNEER: ... — Not Applicable ..' :,A o...� _S.-Gg."*:'44 MORTGAGE COMPANY: Not Applicable Name: this day of_IFd�.p� �,/ , 26N by Name: Address: City: _ State: Address: City: State: Zip: Phone Zip: Phone: (Signature of Notary Public- State of Florida j FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Type of ldentificati `A'" f�9IC44AEL C3RNAR yP Name: Produced ,_: MY COMMISSION # FF230M Address: EXPIRES May 14, 2019 Address: ,a ��a�:9.i:•}J rw,K�;�r� �crcw, Commission No. City: . City: REVIEWS Zip: Phone: ZONING Zip: Phone: PLANS 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 1 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 wqfk or recording our Notice of Commencement Rev. 7/2-014 Signature of Owner/ Agent/ L see/Contractor Sigifatu e of ontractor�cens older STATE OF FLORIDA COUNTY OF 51- eta STATE OF FLORIDA COUNTY OF -5v Liu. i c. The forgoing instru�stept was acknowledged before me this- day %"i 2,04 by The forgoing instrument was acknowledge before me 2-1 °c��, ' of this day of_IFd�.p� �,/ , 26N by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- State of Florida j (Signature of Notary Public- State of Florida ) Personally Known Personally Know ? OR Produced Identification Type of ldentificati `A'" f�9IC44AEL C3RNAR yP Type of ldentific ti '�- Yp 4a�" MICHAEL Produced ,_: MY COMMISSION # FF230M GER14 Produced = IA��' EXPIRES May 14, 2019 MISSION # FF230846 EXPIRES ,a ��a�:9.i:•}J rw,K�;�r� �crcw, Commission No. Ma Commission No.. y(S��it}ty . � susrMNusaySe•wtt cosy '. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETE© Rev. 7/2-014