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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICAB4E IlNFO MUST BE COM. °. ED FOR APPLICATION TO BE ACCEPTED -- / ^� f Date: �• / � I ,V Permit Number: % -V� 4-9y ' Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Building Permit Apprication ��p-� 0)IS— Commercial _ Residential Address: 75 71!Z X = 0 7 U.7 tl W f 1 Legal Description: !T Ltiar G'arncnit' 2 6 36 Jt0 61-k 3 PcpT 1.-6TY5 Ji Property Tax ID #: 5�040,10 AR Lot No.3,,.T *7 Site Plan Name: /� Block No. Project Name: I' �� exurck OF FOJ Setbacks Front Back: Right Side: Left Side: MUUI uuuc 1 wvi n w uc PC[ w[ i ucu unuci uua Ncn uu.—u1CUM au umL apply. Mechanical _ Gas Tank _ Gas Piping _ Shutters A Windows/Doors Electric Plumbing _Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: ; 3 00 Sq. Ft. of First Floor: Cost of Construction: $ Utilities: _Sewer Septic Building Height:1( SOW NER7/,LrESSEE: CONTRACTOR: Name s—r; Li 6tir- LAkEf & ZA, I.J. c Name: Aslnans j(OCFt ic, fcNKFTRUCM u., f GL Address: z Q WDO! i% ltf Rd u' Company: City: 0 D State:_ Zip Code: �l 7 Fax: Phone No. 3 T Z- )7r 3- 406 3 $ f� Address: .2.7� 814- M c dU City: FORS �� C State:_F - Zip Code: 3�iy 17 Fax: f Phone No. 7 Z-14/ Ir 1 E-Mailttrcc i rL CbrporcLtEd RCLoL • C0 Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: A Ftdro C.aNSTrAecfi m l�ii &IfArl •� State or County License: 6&4 JV 60 f S" s If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. ' DESIGNER/ENGINEER: _ Name: Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone: State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: _ Name: Not Applicable BONDING COMPANY: Name: _Not Applicable Address: Address: City: /•. City: Zip: Phone: Zip: Phone: SUPPLEMENTALCONSTRUC� LIEN LAW INFORMArTlON• 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!wil tauthorize 4jt9 permit hdldieritv-build,jhe subiecttsttIucture which is in conflict with any applicable Home Owners Association ru5j,byJ$ws ortandlcdvenarit3 t)t V may -r,%t Lflorprohibit such structure. Please o,��nsulttwitfj your Home n rs Association and4evieW�our deed for apy restrictions whl4hh may apply. In consideration of tide ghnjia��fi�is he st d p tt] I d6,her2b' .agreLlth%*' Igtirirall'r�sp Zi1i I: 4rm� work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. TFie� *o UV —building permit applications are exempt from underg ing a ful!� do�j7rl f, u0,revreF;rgo ;Tddjtions, acce�sor structures, swimming pools, fences, walls, signs, screen rM-ant actAs�ory usesrto ?another non-residential use WAR�V)NG TO OWNER: Your failure to Record a Notice of Com encement may result in your paying twice for improvements to your property. A Notice of Commencemen mast{ ba recg'rdq1118yostL&OI51the jobsite before the first inspection. If you intend to obtain financing, c nsu t With lender o �an attorney before commencingwo or recor 'n our Notice of Commencement. ev. � Si natur f Owner/ Agent/ Le r..tt 1 +r• 11 g t�.l�`a alla�J:1l�J:T1V5 C1 f tr or LicenseHolderr � D��^� it� N:s.:-!?111 STATE OE'F�f� 'j�y,,�7 rqq' 11�;tIr F�QF'f dF C. � TEBf��FL�RpA C�Lt COUNTY �Ya���'��/ C1%NTY OF The fo inginstru �1x'�'.�•iJ+t—�'ccJ{'FTJ„a 1—;j�ajTt'iU� The forgoing inst before ent as acknowledged efo thisf�dayofJ20�by ment�ivas acknowledged me this%�dayo�20�by �tpU!:':�''•�°+ry//�-., ��i'j�r�°''y'�'- �� f GD Dl/�� J1IT' ` 9;,,•,�,"es O C� �� .��.8 .L� (Name o person acknowledgi g (Name of person acknowledging) �D39 zmnr�i � V 2a�a zmg �Nm (Signature Notary Public -State o lorida) ag m � „,1 (Signature o otary Public- State of F onda) P� grom9 J � Personally Known OR Produced Identifi ttl Personally Known OR Produced Identificati Type of Identification Produced a Type of Identification Produced 11tt��•• 2 Coinrl�loriNO:"1�A •*Ju�i'oc���oir h pp a Commission No �� }K3$17 iSe��� REVIEY� FRONT ' (ST�"tiZ.l'�{ SUP.4;�f-{SOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEWS V? ,\• EVIEW REVIEW REVIEi•�RE. IEW EVIEW DATE �'i•.�©��Ja� U • ' RECEIVED :tlJ�Ei�:'t'J C j COMPLETED _