Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED . Date: ���, � Permit Number: LA EIVED Building Permit Application 2 2019 Planning and Development Services nty, Permitting 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: To Select from dropbox, click arrow at the end of line '�l litlt°� }, W 1 � ,liis el13d}!I+� " °l.r 'ttltt,?.� r,;h g. u#F: ' ( a Address: Io f— 66wco8- AU, Legal /a.,35 .;rr:f4.�ti`'M�q..y�9'a�.'%'i•S+..t,y!l'.s.is�y i(I;l;�tl,i.� F ' Description: /d 35 3R Wr. 4T lAJT OF LJ Q QF� i OF KbJVy Ui-S4.) q Ajod S I Ll or- elfti�,e -4t) atAl i=T FOR i6bO rN CMT E 156FT T NS,200ffr i 1f6YS-aF7-t.4n -2&r- Property Tax ID#: ;29-1L9--3a 6C)15'0OD- l Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: N..ilk I`' :Rt l.l` 7u, tlt, ll j S! 1!.f' {i 1 >fY ri)r.�:ti {+u :}- ;(;" Ej`.Yq .l:f t!•.: .i !} q it itl q ,�R.. �[ y, �•}taY , �[='.t ;:YS ..�.y � ..r9 iry�•,�, r ^t t''�. s, i al 36 � s;,sa,'4y�t �qe�iii [�' �I 'I,,,q }�y}'7 '� I t}[ i�'�?�,�,'�r'�',+�,�s f .,te„• #lhsE'� fl'.tl i-.�is�i(h91!1F1 i�t�" '�t+;!Eh{�.lil�r�IE{illi`Fes'h.?;Ctf�d43,�a-0#r.'r iI'+:,'. �•• !It'iil3i�i��!il.:l.l.rl i��`� �r�31�s�l`t i9;t,,." ,''�•1-t�''�Ji�'�t�!,�` �"�.33gsa�!�tts�.,�smle�tK}1"ti��`1'sy� P'�i�'Ufi�i"Y�t. �B 3 t4 t " it° t wamp � 'It1i11t7>s.`!1d'1[IR ti6lFlalhyl;!>u6�L•I{P$1)gt,lfiYl?1„1r€7)yf.:.yil.i'ird.t)s.lr..e,,!. Irrf n- 8.1.4zt,3i{'+UasIiEt"itv; 2iil V9{3i1}; fiqs,It,}; ,'rzy y iY.S!ti'Ul ii iflI,sthlf;y,U.q.+.i•!'SrdSsf{i.lI3I/il!li.¢�9131,.}ne1nf 1?.}i•y,l)Ek71:C.,+�._i!'qcit,iSHsi7�i o>n, !}°, to�lltf�fx{An!R 7.•w.0 t'!h�-tA'V'10'01`111 .1 . t BI Additional work to e e orme under Is permit-check a . appy: HVAC lie Tank Fas Piping Shutters QWindows/Doors Electric F] Plumbing 11 Sprinklers _ enerator le7pr��`l,Y1u1*,,,fi,H}•�l',�.�SL LjC3 , 3q L1Roof � Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ , �oo.60 Utilities:OSewer 11septic Building Height: .ih- ,M:,.,;..,.n�tF7,tt4• :�t'(-,.:.,�,�,`qs;4�I�R i!��',r 1[Ni i.y'tb7°�i[ '(ai .. �, -�+j)/,�-l�l,�fi'II�.i;s�i,!in`t}[I�t•11 f}1 ,; �j�'i);t�f t 0I 1�:i aau;t.tu1-YY Ty �s�{t rt�,:•�,<t.4 ,47"�}.i y t xtp!'',�t!T�'i�:f{FS+Ita+!}Y 'St,.����+' t1��a•'.'�it F��F.+;•. 1"If;!I 1,t'#i 1..l i MI Name LCIII)i i- t)JCL bCpnSt Name: mimes L MQfu�� Address: 16loK/- (0tar-)ne Ave • Company: City: R. OfeC_P-, State: Address: { . > Zip Code: ��cl�f 5 Fax: City: I ' CT State: r- , Phone No.- 77o1-Qo'6-60010 Zip Code: .3L/cl8oZ Fax: E-Mail: Phone No. 4/66 Fill in fee simple Title Holder on next page(if different E-Mail: 4nuru5 Q ©a(T e-cy/n from the Owner listed above) State or County License: EC I�n�I(oy3 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 11141010NU 11.1",V M) vo �� I I ;A"' ON I IN1,0911".1 I ft,"ag I a W 11 I'M lug) DESIGN ER/EN GIN EER: 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 theermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or an9covenants 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. Siga re o wrier/Lessee Contractor as Agent for Owner Sign of Contractor/License Holder r k STATE FFLORIDA Lk. STATE OF FLORIDA COUNTY OF COUNTY OF LA '161L The tql-'ment was acknowledge before me The NAolng instr ent vvzp acknowledgeoefore me s O'ng n 20J�t by this ay kp' 1 20 ay of ri by Name'offperso making statement Name of per n rn-al(A statement Personally Krim OR Produced Identification Personally Known7 OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of (Signature of Notary Public-State of Florida KAREN S. NIELSEN X13151310 V R E N S.( )_SEN State of Florida1S@,bqJY Public Commission NSFPY PUB Commission No. CorfirrTission # GG 07484 f Notary Public My Commission Expires "!:.State o G 207484 -=- Commission # N Public lic )_SEN N 'E7] Floridada N Public S a'y u li'l S 'L S P 7" t7 d q y 4J134 4'b 'i a- L n .4 G 0 07 s 0 Expires s # I�7. 0 'o n n Ex on GG 207484 2 0 i June_'12, 2022 mv commiss on Expires June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEG uffT_� VE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17