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HomeMy WebLinkAboutPermit Application 4.10.19ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date Permit Number: r Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 452-1553 Fax: (772) 452-1578 Commercial Residential ' PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION;_ Address: 5713 I r -pat_ �r%re 1=�. l���rcG, 1-L- _ Legal Description: Property Tax ID #: / oZ Site Plan Name: �L Project Name: �--[ice-, Setbacks Front Back: Right Side: Left Side: Lot No. Block No. DETAILED DESCRIPTION OF WORK: ?ma y.G444lrn rdatF C -P 6' Wcc, "da� �acqt� ftr%rt,cot ccar ce � CONSTRUCTION INFORMATION: Additional work to be ertormed under t ispermit - check all trial appy: HVAC Gas Tank ❑Gas Piping Shutters I Windows/Doors 1=1 Electric Plumbing OSprinklers 1:1 Generator 1:1 Roof Roof pitch Total Sq. Ft of Construction: S�Ft.{ of First Floor: Cost of Construction: $ 1.2�00.00 Utilities: LJ Sewer QSeptic Building Height: OWNER/LESSEE: CONTRACTOR: Name c_1%V%?_ evti Name: AC. -e- 4 Id e Company: y11C'44r V1_% Address: 13 r- eL a (yC'z oc City: F -A-. yi.crcre State: �r Zip Code: 34'102- Fax: Phone No. Address: Q(20 Cpoval 4oc City: e',' ._ __ Stater Zip Code: 3q IS3 Fax:172-8,79racy` Phone No. E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail: Cc� e_ c'.0 eSri.&" alto r -c cw� State or County License; c�G' mr1tSS?� If value of construction is $2500 or more, a RECORDED Notice or commencement is requirea. SUPPLEMENTAL CONSTRUCTION' LIEN LAW INFORMATION: 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: f11AiA1CD/r•nnTonrr�n n��a.�,..�-. _ PLANS - -- - ••, • • s W" ,+rr,LJW 1 I _ Hppiicarion is nereoy 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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in contlict 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, wails, signs, screen rooms and accessory uses to another nom -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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NPXICE OF COMMENCEMENT" Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF L U C 1 tf> COUNTY OF sv The forgoing instrument wa acknowledged before me this /?7dayof 20%cfby t L Name of person making staternent, sonaily Known OR Produced Identification Ty en�irir�2 of n Produced The forgoing instrument was,acknowiedged before me this 0 day of 20-P by ( r Name of person making statement. ersonally Kn�icat>i�onl OR Produced Identification Type o ent Produced XR1/�yr; 01 *g ��� •. dSSiON ��._ SSIoN : '[�9� X57 r2 (Signature of Nota Public- Stat fFjo ?o�,T�•: �,'°/••• (Signature of �a Pu ic- State f Flo Commission No. si y * '(Sal* {Sj� � •fir a� ... : * •� Commission No. (2a . Zr ��`.' 0 dih`tit . � -. ae .• 04•. REVIEWS FRONT COUNTER ZOpjlt�c lu rI OR PLANS VEGETATION T�. 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