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HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a (? Permit Number: 4.+�"l Jy�✓ 4 QED Building Permit Application APR 2 12020 Planning and Development Services fteffilting Department Building and Code Regulation Division . Vit: Ducie County 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial, Residential ' PERMIT APPLICATION FOR: Address 2 I© ' Qa d yr c l o ti c Legal Description: me..a0 VV D o� (A yl i'E Property Tax ID#: 1J /3�- 60S - IQ a 1 q - ao — vl Lot No.� Site Plan Name: !tl / Block No. Project Name: T)oa k4l2— Setbacks ' Front Back: Right Side: Left Side: } A d /0 D g:nJh I crf ACGGy"c�f�H c1h 7TtrJ 7�A 1' �r iP Additional work to a pe -orme ,un er tis permit—check a that appy: Mechanical ^Gas Tank _Gas Piping Shutters _Windows/Doors Electric _Plumbing _ Sprinklers `Generator _Roof Pitch Total Sq. Ft of Construction:, /1./,� Sq. Ft. of First Floor: Cast of Construction:$ �,3,�" Utilities: Sewer _Septic Building Height: �$�/ , Name l> + Name:�' A Address; tl'Y1 L?,✓te i a&a .,Company:CoAJ 'orC''iS� City: �eCL-e— State: Address: 2 i ., Zip Code: ,7:S qg sJ Fax: City: W. 1114✓ir State: Phone No.S7d a.2-6 0q7 Zip Code: _Y //? V4� Fax: 1?2• cj /des s' E-Mail: _5:Z = 7 q J I q b Phone No 772^ Fill in fee simple Title Holder on next page if different E-Mail r0,0W7, y 121 C 60 'T 049. C'd�✓I from the Owner listed above) State or County LicenseC ee,J lrlso I ` if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I M DESIGN ER/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: _X_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 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:"roomadditions, 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 lerider or an attorney before commencing wyork or recording your Notice of Commencement. Signaturt'of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF sk- 14cxs COUNTY OF The foLping instrument was acknowledged before me The f sing instrurlient was acknowledged before me this I t� day of 12 0-1 L- this for of # 201D by L, 20 ZD by Name of person making statement. Name of'person making statement. 1 -11 Personally Known OR.Produced Identification Personally Known OR Produced Identification Type of Ideplification Type of identification Produced V1W1lZ41DIPr C)2AVS'I-,- U40Lge- Produced RotxQ A- 00VUlt, Uc-&&SC AI e c�'L.�`aa l'J �.fi� 4`��F�o hti 'L1's (*rkt-Gire 6f Notary yw6lie-StasLejoLk6rids) ure of Notary Pub!f K-Stafe of Fl6ii6%;4 V44 00 Commission No. Sea mission No. be o�a �F fav REVIEWS FRONT ZONI ISOR PLANS VEGETATION SE ANGROVE COUNTER REVIE VIEW REVIEW REVIEW A REVIEW DATE RECEIVED DATE COMPLETED iev.