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HomeMy WebLinkAboutBuilding Permit ApplicationALL PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED yy�� q Dat Permit Number:Q20O 1 • 00(0 U Building Permit Application Plan Wng and Development Services Building and Code Regulation Division 230 Virginia Avenue, Fort'fPierce FL 34982 Pho�e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PER AT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: b "J `% I / c„ !'r, A--e 1�—E'r c l Ye,C9 - Legalc esription: P _. I Property Tax ID #: 13 ©� ` (v �_; 6 a. e�w - Lot No. Site Plan Name: i Block No. Projegt Name: Setb cks Front Back: Right Side: Left Side: i s DET =1LI=DrDESCRWT'i�ON'QF WORK C��' - r �TRU d , �O�N�I fORMATIO'N - Add it 1IHVAC ona wor to e e orme under this permit - c ec a E _-'� Gas Tank ®Gas Piping apply: ❑ Windows/Doors I Electric Plumbing _Shutters Sprinklers Generator g Roof u Roof pitch Total q. Ft of Construction: �'� S�Ft".j of First Floor: nSewer Cost o Construction: $ S� I Utilities: ®Septic Building Height: O ELASSE� 4 F CONTRACTOR - _ �rs Name C .�..rL:,c 1 61.cA Name: A d, %,J • n Addre s:.1L-, v C-T ~ Company:�.Z:a City: • ( State:, Address: 7%1 �S C�) e Zip Code: de• Fax: City: �� - t- d rt Stater Phone No. Zip Code: 3'i 07 t`rX Fax: 0 t/- //a 7 E-Mall: Phone No. q- g�S a - Fill in I ee simple Title HI Ider on next page ( if different E-Mail: LJO 4c/��,-� from he Owner listed above) State or County License: l h G 15- 1 3 If valug of construction is' 2500 or more, a RECORDED Notice of Commencement is required. , 0. S ``, P,LEI�IE G' TA'L CONSTRUCTION LIEN `LAW IN'FORMATIO.'N -t ' ; DES GNER/ENGINE _ Not Applicable MORTGAGE COMPANY: Not Applicable Na I IR: e: _ Name: Flask I Add Address: Stater Phone City Zip: City: State: Zip: Phone: FEE IMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Nary Name: Add -ess:' I Address: City+ City: Phone: Zip: Phone: Zip: UW IMFK/ iLUIM I KAL I UK:AMUVIT: 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. Luc a County makes nor that is granting a permit will authorize the permit. holder to build the subject structure which s in conflict with an applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such struCtL re. Please consult with your Home Owners Association and review your deed for any; restrictions which may apply. In con ideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the ap roved plans, the Florida Building Codes and St. Lucie County Amendments. The fol�owing building permit applications are exempt from undergoing a full concurrency review: room additions, access I ry structures, swirrlming 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 impr vements to your property. A Notice of Commencement must be recorded and posted on the jobsite beforip the first inspection. If you intend to obtain financing, consult with lender or an attorney before com encing work or recording our Notice of Commencement. I, i I - - Signa ure of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/.License Holder STA E OF FLORIDA / STATE OF FLORIDA , COUNTY'OF - G� �� COUNTY OF �� Z --c -- i The f rgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 1 day of _:7-- Yi 20 -70 by this "7 day of 20a0 by i Na of person) making statement Name of person making statement Personally Known t "OR Produced Identification Personally Known r/ OR Produced Identification Type of Identification I Type of Identification i Produced I Produced rr- (Signature of Notary P bl'ii*_ of Floes Y MARTIN (Signature of NotaryPublicVllt�ljd ior' :b • ,y Notary Public- State of Florida tW84 Public - State of Florida Com i r = GG 346354 8: Commission x GG 346354 Com Ission No. ;• P; y4�'M Com es Jun 1B2023 Commission No. My E!e®I xpires Jun 18, 2023 bonded through National Notary Assn. onded ti,rough National Notary Assn. •..... REViEW5, FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DAT_ RECE VED rc�oM�AT LETED Rev. 8/2/17