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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COM Date: J 9 LETED FOR APPLICATION TO BE ACCEPTED Permit Number: Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Building Permit Application RECEIVED JUL 2 0 2010 Permitting Department Commercial Residential St, Lucie County PERMIT APPLICATION FOR: P'R PC?SED INPRQ,�UEMENT L©CATI.aN Address: 1-7CO JqG 2.ST(4 L-,/Fife- ,. / _ Legal Description: i ��✓" K- q#) r S L K� 3 Lo'r 16 C M &P 3N a z3g ( o (L Property Tax ID #: 34 ,I rQ - S(0 - 0 00 Q " 000 - D Lot No. d Site Plan Name: ES-r"I i+ Ley-- Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Ptrn(o w1 V i-ed10VA--W A OR-a,Aevy 0A Uma5 Am Mika .V0A,rAJg Fod (JMI Additional worK to De pertormea under tnis permit - cnecK a _Mechanical _ Gas Tank _ Gas Piping Electric (% Plumbing _ Sprinklers Clfc,kii/► ON 4fLI-4l1 (11 he 21,1;7 !fin CAS me , 1�1 at apply: Shutters _ Windows/Doors Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �j GU(r Utilities: —Sewer —Septic Building Height: OUlINER/LEAS�SEE: CONI"RACTOR: Name jn c, Pr SOS fie_y- Name: Company: ,, Addre(ss�: City: I I �5 T�� C.f' �. State: Zip Code: Fax: 7WL- 301 "' A59 Phone No. TT 3.' 1- /q Sq Address: City: State: Zip Code: Fax: Phone -No,•, i'' E-Mail: �oSi'e!'Sc� (,ASS(2-) Wy K.+; 6 Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail State or County L•-icense If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. StlPPL �MENT L CQNS RU � ION LI LAW IN FORMA 10 MORTGAGE COMPANY: _ NotApplicable DESIGNER/ENGINEER: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: 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:'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. �l • 'gnature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of .TU,,4 20_tk'by this day of 20_ by MAt. r Name of person making statement. Name of person making statement. Personally Known C2L OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public tate of Florida) (Signature of Notary Public- State of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING J Pf/i PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW!`/ w REVIEW REVIEW REVIEW REVIEW DATE RECEIVED < w' a M Co•, • DATE C o C COMPLETED am -n Nev. N9. w 0 (D �Qv