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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: J �� io1 -Permit Number: aco50 r, .T � Z ,. AaunoD apn7•aS C,C?t h1' T:3R° 4utWJJadaa 6ulaalwaad Building Permit Application ROZ L I OyW Planning and Development Services Building and Code Regulation Division a3A130321 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line D IO / NON I'POPOSE11VPREMET LOCAI . r {z, ,. wk i . . , ' .. _: Address: .143 E . E.f i-e„ a:f1 —T r - c 1ef" 3 ..,j ' 3 9 Legal Description: 1 ' - e-o mil j i card Property Tax ID#: 14 ?? at —000 --000 q Lot No. Site Plan Name: Block No. Project Name: kyun it C <.i Setbacks Front Back: Right Side: Left Side: DETAILED`IDESCRIPTION OF WORK; Chair O Q.. C eC�C CLceC'nI-1- a 3 To,A,./ • /6, ,_s-e'-%f CONSTRUCTION INFORMATION - F ' -.n. .-`, r. .....-. ,.:.:..,.3. - r n,,a, i.,z: . .. Cis..,: .. .�� .. t°F yz.rz z� ....: Additional work to be performed under this permit–checkall tha apply: ENVAC lel Gas Tank Etas Piping lel Shutters El Windows/Doors 13 Electric 0 Plumbing 0 Sprinklers 1-1 Generator Ell Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ '-- GA 100 Utilities: Sewer _Septic Building Height: t OWNER/LESSEE t ', , g x RACTORtf Name:3 .drOCk.Ta41 cE 3 LLC CONTName: 1)0.'icL grn1 ' Address: 3N S Er i-e,1) Company: Pe&tj AC Services, LLQ City: r---I-- Pie-rc _ Stater=(. Address: 532 Biu-) i l&recn+i 1e PLi 1 lit Zip Code: 31/0 CI& Fax: City: Po(-I- S' .]_lJC.k2 State: l-` Phone No. -?!,)- —' (f - f i Zip Code: 3‘11 9 6 Fax:77 --ci Std -,Si l E-Mail: Phone No. `T72 B1 I –15C20 I Fill in fee simple Title Holder on next page(if different E-Mail: ill{a g Zi'c..d.-ti OC (vice . Co in from the Owner listed above) State or County License: CAC I$1 I 6 a3 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 1 11 1 rt ilk ik t sS €-4,&„k„..i'4 Sia k.-•'."• vx x• '"n ' 5 s .,. ;: ...•v ..<a- �.,.3`t.._. ,�.,xaf,;za _ ,n.�..�� rf u•5 .va �-: < e DESIGNER/ENGINEER: ,-„_Not Applicable MORTGAGE COMPANY: Not Applicable — Name: Name: ,I Address: Address: II • City: State: City: State: II Zip: Phone Zip: Phone: II i FEE SIMPLE TiTLE HOLDER: Not Applicable BONDING COMPANY: ,___-Not Applicable Name: Name: Address: Address: J 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 t will,in all respects,perform the work j 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 l improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite i1 before the first inspection. If you intend to obtain financing,consult with lender or an attorney before commencin: w , or recording_nut Notice of Commencem- IIIIMM ©_. ` . Signature of Owner/Lessee/Contractor as Agent for Owner Signatur-of Contractor/License Holder E STATE OF Y OF 10(-1- ?O(-1- :.S-l-; �'iCfid, COUNTYOFORIDA 04 • The fol.-going instrument was acknowledged before me I The forgoing Instrument was 9cknowiedged before me this - day of i(a-r 1 , ,20 by it this ?-7 day of Pi ar :it-• ,201a by la.1/1c1 ?}On* c\-etc s Thewi . 4nd€ r Name of person making statement Name of person making statement Personally Known X OR Produced identification Personalty Known k OR Produced Identification Type of identification Type of Identification Produced Produced c------ -- C--__ .4',Y V`A Q�c-— . Z� 'i - ,• t• >..-G. i , 1 l AlLam.. ;(Signature of IOtCry Public-State of Florida) (Signature of Notary Pub' -State of Florida) c, y4-- 1..., s F i'*._ ( >al) Comm y•s■ '■.,.•. �� •—tbastyptivioastfr 04 Swift & al) L ,ictt Daniel Michelle Darnel , s F94.FF, � , ■ ��, 91 My Commission FP 908495 g x tis' s, a MO 0a 120” it RE. .-f FRONT ZO1rG SUPERVISOR PLAN' VEGETATION. SEA TURTLE MANGROV COUNTER REVIEW REVIEW REVIEW REVIEW; REVIEW REVIEW DATE RECEIVED DATE COMPLETED I Rev.8/2/17