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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPL:ICABLE,INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED, .Date: � Permit N ,per: U 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: Address: 116 So- cL - C� Legal Description: 1 %Je.r PO-4—t . Lin J -7 Biecle %2 LVOr I 3q 12 Property Tax ID #: 3 q I q e 5-SO - ®©I 1 - ODES - T Lot No. ( S Site Plan Name: Block No.. lot . . Project Name: Setbacks Front Back: Right Side: Left Side: aitionai worK to be pertormea unaer tnis permit — cnecK aii tnat apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric. _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Cost of Construction: $ Sq. Ft. of First Floor: utilities: _ Sewer _ Septic Building Height: _ rvan�C .l.yw �J�uu�V{T l.v uv�c,vv�;�r Address:.11,10 City: PEE+' :. _ . State: �1 Zip Code: 3L9 93 Fax: Phone No. " 171-�Z-e--1311Z. E-Mail: tonaltr�'Za9ainc�n�l.[ O►rc Fill in fee simple 413 le Holder on next page ( if different from the Owner listed above) Name: sue" Company: nrlda Ce Address: 1767 Scy Ta-ov✓s La," City: P5 L State: IN Zip Code: Fax: "M 336-S16(f Phone No. -715-13q E-Mail: 1i�a%.r►C? as yrj^oo. Gc State or County License: 01 f If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. EER: Name: Not Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY:. _ Not Applicable Name: Address: City: State Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address: City: 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,tlie 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: 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 commencine work or recording vour Nntirp of rnmmPnrpmpnt Signifdt&of Owner/ Agent/ Lessee Signat o Co ractor/License Holder STATE OF FLORIDA STATE.OF FLO& DA n COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The for ping instrument was acknowledged before me this day of 20_' by this day o 20 by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification , Personally Known �OR Produced Identification Type of Identification Produced Type of Identification Produc Commission No. (Seal) '' :r MISSION # EE1637 Commission No. I(2��Ir EXPIRES Febnory 05, 201 (407) 3994163 FW ftN04 ,=n REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED le Name: Address: - City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: MORTGAGE Ct'9l%%?ANY:. Not Applicable Name: Address: City: State:_ Phone: BONDING COMPANY: No't.Applicable Name: Address: city: Zip: Phone: OWNER/ CONTRACTOR. AFFIDVIT:.Application is, hereby made to obtain a. permit to do the work. end installation as indicated. I certify;that no. work.or.installation has. commenced pior to the issui3nce of a .permit: . St. Lucie County makes no representation that is granting a, 'it 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 thegranting. 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 e'xempt.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 commencing work or recording your Notice_:of Commencement. Signattiti of OwXer/ Agent/ Lessee I Signet o Co rector/License Holder STATE OF FLORIDA STATE OF FL OR DA COUNTY OF C34, COUNTY OF The forgoing instrument was acknowledged before me The forgoing instr{ment was acknowledged before me this day of AWu . ��_ 70 `'bY : ° this day off 1, 2U by U L. �— . f_,H�n �P_so n (Name of person acknowledging) (Name of person acknowledging ) l\LQ � � ��r.��; • (Signature of Notary Public- State of Florida) A� (Signature of Notary Public-, State of Florida j Personally Known L--*�`'OR Produced Identification ; :.... Type_of Identification Produced Personally Known •OR Produced: Identification . ` de ntifi n u catio `Prod c .... Commission No. I✓ jq�{�(� S Notary Public Staid Deborah. S :Rowell t° 50 Commi ion No. y 1�2 �MI3310N # EE1637 �� .. My commission EE 1.6066 ,•'. •� I ES Feft lly 06, 201 . Expires 05/06/20.16 . (407 31iB�163 FWONOta 'Wri REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE .' RECEIVED DATE COMPLETED ov