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HomeMy WebLinkAboutStickney App SLCII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: Date: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Residential Phone: (772) 462_ 1553 Fax: (772) 462-1578 Commercial Site Plan Name: _ Project Name: !gJ:5c," .,A _.....__..,..,.. _...-...yr.:-�am_..sr':..-R.f .....4*. w 1;'„�'•°�i m�tiS' +_a.•.�"�vi9 � ..: .:��.. ,°yCR � �ih.. _... t_•zrt; .. .x Additional work to be performed under this permit- check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters V_ Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft or Constru-tion: Sq. Ft. of First Floor: _ Cost of Construction: $ q, �% O • can _ Utilities: —Sewer Septic Name_- Address �'}�'}'ci -Wee Cite: .._pt Sd� State:01 Zip Code: l4� S_ Fax: Phone No. -►-ta�t� 30112- E-Maii. .— Fill in fee simple Title Holder on next page ( if different from the Owner listed above) ✓Windows/Doors Roof Pitch Building Height: Name: ✓nn; Company: MLA U 00(1'�C¢Ar Lj�A PtfSi Address: 110 B T©t►1akwy- br` D°°r City: aria,jlnrlaur P'lk, State: rL- Zip Code: 3a9'bl Fax: Sat- -7�r-,423 Phone No -7 7 2A- 337' 70 E-Mail,9LufcSQ- ''(or•- (MrleQC•N,+ State or County License_ Qcl'�1 7 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. if value of HVAC is 17,500 or more, a RECORDED Notice of Commencement is required. DESIGNE Name Address: City: Zip: NGINEER: — Not Applicable Phone ____ FEF SIMPLE TITLE HOLDER, Name: -- Address: r,ity• Zip: _ Phone:_ State: ___ Not Applicable MORTGAGE COMPANY: Name: Address: City: Zip: ..___-! Phone: BONDING COMPANY: Name: Address'. City: Zip: Phone: — Not Applicable tate: Not Applicable )WNER',/ 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. it. �ucit r:o�i tv irrake:; no rep: esentation that is granting a permit will authorize the permit holder to build the subject structure which if, n conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such Aructure Please consult with your Home Owners Association and review your deed for any restrictions which may apply. n consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work n accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. he following building permit applications are exempt from undergoing a full concurrency review: room additions, cces,ulr;' strtici urE s, sWinming 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 'TWI=:iE FOP LMpROYEMENTS TO YOUR PROPERTY. A NOTME OF COMMENCEMENT MUST BE RECORDED AND :HOSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:' __1 Signature40fwner/ Lessee Contractor as Agent for Owner Signature of-contractor/License Holder COUNTY -- The fo oing list calr antwa a�cr owien td .;cfc,re me this day of �. 2+f, by Name of person making statement. Perronahy Knnwr' Type or ldenvfl at or Preducl.ad. _..__ ._._.. _... OR Produced Identification X2. L,/7//-. (Signature ; otar Public State of Florida ; COrnrnissic,n Noy i Y"vi� NotAtl�lic State of Florida Ashley M Antonelli <; g My Commission GG 152970 REVIEWS I FRONT'^"' XDTW 1 y I COUNTER REVIEW REVIEW DATE RECEIVED DATE COMPLETED STATL OF FLORIDAD CGUN7Y OF G tCAJa-1�`� - 1;le ioi uing it strument wa acknowledgbefore me this -" day of 20 by Name of person making statement Perconaliy Known �_ OR Produced Identification i ype of identification Produced-_._. _ tore �¢Y 01` Notary Public State of Florida Commission No. AoeP4 Antonelli My Commission GG 152970 -- n Expires 10/18/2021 PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW