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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED nos {fin Date: Lp �-I J Permit Number: oJ' VIJi� 776.1/C41RECEIVE!) C (1FJTY FLORID /2k --- MAR ®.''1 2818 Building Permit Application Planning and Development Services PM's/lifting Bepprtment Lucie Cq t 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: !I PROPOSE© OROVEM "LOCATIO o Address: 3l4co -1-kC)61L)' R- C..1g _.7 e--c ?ctS c jc� &l 1 3cL e--1,Sr"-- Legal Description: C £CV---S\0C 71.c"'C (1/4.)0 ) ( OT I.'Z Property Tax ID#: Z ?Sc.-c.- \-1 - C:C>C'>- ' Lot No. \Z Site Plan Name: Block No. SS- l2 Project Name: Fig-4'3e-G----- Setbacks Front t (� Back: Right Side: Left Side: =Al LED DE�SCRIPTIONr WORK �� 99 '3Tr/c( . (1` PtC. 3 M j3 uM`. kV S l$ �>,C�L�� �--�k`C lam., Cly S CONSTR CTIONINFORMATION° 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:$ 2._ SC.) Utilities: _Sewer _Septic Building Height: OWNER LE SEEg ' ° ffi` CONTRA OR • Name (yeart \ Name:'-r-o0Ce---f s'TiS Address: 3l-t(p''_-Cl'06-7 M-7E - C-L9-- Company:FSNc u1 City: fz5(1--C P(S State:El Address: 5<.-fTS ti.)kJN _V1 Zip Code: '3<-6`-(.r— Fax: City: G iz7 57 C..eiGI r State: F l Phone No. c 7r-L3'{2 Zip Code: ?'-('S Fr-3 Fax: E-Mail: Phone No SC. '' - 55 - Q 3 bd Fill in fee simple Title Holder;on next page( if different E-Mail f Jc_€O[KJ &5 & . from the Owner listed above) State or County License 3 a5 3 q If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Si PPL@MENTAL CONSTRUCTION LIEN N Uy'I INFORMATICAID . ° Y 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-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 work or recording your Notice of Commencement. f2-------- . : ........—__ c 2 --_ Signature of Owner/Lessee/Contractor as ge r Signature of Contractor/License Holder — STATE OF FLORIDA STATE OF FLORIDA , COUNTY OF ',�L,� �,z 9— COUNTY OF akUQkQ The forgoing instrume t was acknowledged efore me The forgoing instruj !t was acknowledged before me this I day of L f .J� ,20 /j by this I day of / 1 V.? , 206 by q43i0A3c S-Tcrik. . " (Name of person acknowledging (Na - of person acknowledging) IIP I 4--------- ...... F._..., ) • 1-----P),th,n W.\--dr 4b-L •— -.' cif 4. -UC/1(------ (Sig atu a of Notary Public-Stat f Florida) ignature of Notary Publicl.}tate of Florida) i y Personally Knovr°n 4j ,wti I( atlon Personally Known ,.o!;!(14i ProdLIEUEzNn\`iiii;.IiibhRJ Type Q \�`erP�4 r -i.° �.sState of Florida-Notary Public Q T e of Identifi t'� a-. State of Florida-Notar Public Type of Identificatior ,;, Produced =2 "_" Commission #GG 270079 Produced sy;^,a Commission # GG 270079 �^oafp S� 10.1 s5 My Commission Expires +,f tl My Co-mmission Expires �'n„�\\\ October 22 2P22 Commission No. Octobe,r �2��22 Commission No. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED. DATE COMPLETED ev. 7/2014