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HomeMy WebLinkAboutBuilding permit appALL APPLICABLE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Z() Zv Permit Number: �. I. Building Permit Application 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 APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: _3z_r)l t_JV1J DOCL(1 � V-JOA4 Legal Description: W' cka_ Walter 5113 LG.t IC-) Property Tax ID #: y''--1 3& " S 10 _001 `f --(YC' F Lot No. i C Site Plan Name: _ Project Name: B.": �_lief Setbacks Front Back DETAILED DESCRIPTION OF WORK: Right Side: Left Side: Block No. 14e fn0ve ma-►c�1 c.t o c�iec�, rent ► to eeAe.. L 1 rl�}a11 Se4F- �d�ne�esx +-iY-ler(� yr r�� anol ins+aU +wc plj cno&tZ-�ed Acre rock �o to,�► Siv�2dar�a ..lr'tS-trx 11 5 J me �Cil r�c-F. CONSTRUCTION INFORMATION: Additional work to eoej r orme under this permit - check all apply: ❑HVAC L__J Gas Tank Gas Piping _ Shutters � Windows/Doors ❑ Electric ❑ Plumbing Sprinklers ❑ Generator © Roof `7�1 _L Roof pitch Total Sq. Ft of Construction: 2-_' 3 S . Ft. of First Floor: Cost of Construction: $ Z(o� S. c c, Utilities: Sewer F_ Septic Building Height: Z�-- OWNER/LESSEE: CONTRACTOR: Name Alicia ) }fir- Name: Address: 72.1 SL"GCft-xt-) i31JA T� Company: C ki ul Rea cef--', --Ent- City: uc"( r- State: r L Address: 33111 5 C SIG der' f -± City: 'S+J r+ State: _`A Zip Code: .3JKlCt�l Fax: Phone No. TT'L - t I I+ c' Zip Code: 3LFC1 17 Fax: :13 7 - Z?I - I(o E-Mail: Phone No. + - ZY 7-9 Fill in fee simple Title Holder on next page ( if different E-Mail: UC (M ►i 5 ca r� �fCX��- Om from the Owner listed above) State or County License: (-_(: N If value of construction is 575o0 or more, a KtLUKLJtu NOUGe u, �.urnrncn%.cn1cnL 1c4uu cu. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao tilt wal k d1lu 11 1Jld K 'U" aj ,., ., I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure structure. ture. Pleasecconith sult w thpyoiurHle Home Owners ome Owners Association son and reviewylaws or y your deed or any restrictions nts that which restrict a. prohibit such 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 rnmmencine work or recording your Notice of Commencement. a Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF The for oing instrument was acknowledged before me this 1Tc day of �_,%(,`'f 20-12-0 by Name of per on making statement Personally Known Y 0 OR Produced Identification Type of Identification Produced �� V (S' 7reNublic- State of FloridaCoWos 5 ,5�'t,,N*)EGAN CRAWFO I� MY COMMISSION # GG2f EXPIRES. October 03, REVIEWS I FRONT I ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF The forgoing instrul t was acknowledged before me this � day of J •�+ 20_�O? by 0 L Name of person making statement Personally Known OR Produced Identification Type of Identificatio Produced iature of otary Ptic- State of Florida ('- GAN CRAWFC mis on No. vl �e COMMISSION 4 GG2 Pa EXPIRES October 03, of c� _ _ _ _ _Ivv /--N EA SUPERVISOR I PLANS REVIEW I V EGETATIEVIEWON I S REVIEW LE MREVIEWVE