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HomeMy WebLinkAboutBuilding Permit Application Cue floux All APPLICA E INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: JUL 12 20119 Building Permit Applicati f1T• Lucie County, Permitting 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 _ PERMIT TYPE: �_` Address: kaa La t-- 'Qf kz -T"1 L r T�T feP -P- Property Tax ID#: L3 2-3- 701 _ ob 00 0— Lot No. /3 Site Plan Name: Block No. L Project Name: �- -" r�' .. t �`N � rr �"'y�•5�. .*,� c{+. r�`"3�"b k-� �`c-.,Yx�,b � ,��N`3`a� p©o r- ag' - g Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters indows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq.Ft of Constructir - Sq.Ft.of First Floor: Cost of Construction:$_ t �� Utilities: —Sewer _Septic Building Height: ;gK .v W. er ti 3' � 5:�ss,��' �,,. '' a y, �.^•�'.+ r� '� ° AQlliarGNE 712 E cry � �� ' CQ lT4RAGTQR 1 �� t *�,ca- � ,��..r.-- .•..�:.. r.x.;. a " •u":c•", :s' x.�F _. :r.. ,u-_». 'r +1_.,i ...- .s R.2. Name l `I//u 60CL-1Als Name: 2/ -b Y06;- Address: gqf`23 L-aN�Scrr►��� AJC T,�. Company: City: . pfk% -" State:PL Address: *171 SCs 2a g -'T map Zip Code: -34q'ftr- Fax: City: State:�L Phone No. Zip Code:3 Y S9 Fax: E-Mail: Phone No 216-- Fill In fee simple Title Holder on next page(If different E-Mail (" Au 1 y oL.6-6- from 6-6from the Owner listed above) State or County License If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: i 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 Coun�v 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 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:'SOUR FAILURE TO RECORD A NOTICE OF COMMENCE ENT MAY RESULT IN YOUR PAYING TWICE FOR IMPRt EMENTS TO YOUR PROPERTY. A NOTICE F COM CEMENT MUST BE RECORDED AND POST ON THE,' B SITE BEFORE THE FIRST INSPECTION.i qu I ND TO OBTAIN FINANCING, CONSULT WITH Y RONO, OR AN ATTORNEY BEFORE RECORDING Y U O E OF COMMENCEMENT' VV Signat f er/Le F./Contractor as Agent for Owner St atur f Contractor/License Halder STATE OF COUNTY OF FLORIDA SA— t - �� COUNTY OF FLORIDASTATE OF Lu The forgoing instrument was acknoo–wlediged before me The f r oing instrument wa acknowledge before me this ray of 20 by this day of t��20 by Name of person making stater t–T Name of person makingstatement.-/ Personally Known OR Produced Identification Personally Known OR Produced Identification Type of identification Type of Identification Produced P( – 01 Produced (1 ) (Signa t Pu lic-State of Florida) (Signa re of Notary Public-StateforIda) `purr+q, � bry, Comm i i,� oe�_ EDEN VAI{k��}N CommFI'----� t Frorida-Notary Public �_ s tat " VAU HN =' '= Commission #GG 27007 =� S f Florida-Notar ^N t. R� vly 43&t orimIS310n EX ireS ~� o «oPO°� Myy�C 27 079 REVi A8 UPE iSOR PLA >zCs``kTATiONOoiJ{ii�xpi WA-TE ROVE W REVIE 022 R lEW DATE RECEIVED DATE COMPLETED Te—v.