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HomeMy WebLinkAboutBuilding Permit Application (2) L) All APPLICABLE INFO MUST BE COMPLET&,' 011 APPLICATION TO BE ACCEPTED u Date: 4 1 1 Permit Number: E E 1'.'-u JAN 0 0 2017 Building Permit Application Planning and Development Services Building and Code Regulation Division 23,00 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: Me� q ' R®PQS�� I PROVE EN Q I® Address: Z&y )l ,mod ccJG �lvg 2 eec� ��•. Legal Description: Z,c3/zeG'q©6--/ �0aalG-ow." _Z,p T /8 41-& /8 L o q4Ac - /5MO sue" CA� 43 Z/Lb�,6 307-213 Sri' Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front ._'5" Back: 0t7/ Right Side: c349 Left Side: j D IL 00 ►MEN- CIP 0 J ®F I M O ji o C°i�2 T Gay S` ao �0, 4 T CT Q ' FOR+M ION. Additional work to be pertormecl under this permit—check all tat apply: _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors Electric _Plumbing _Sprinklers _Generator. _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: /Z 0 O - aD °° Cost of Construction: $ /f0 Utilities: _Sewer —Septic.. ._, .Build.ing Height: 0 ER LS�SE CON Name ,'DGj A_) 9,4 6.b4,o9/ Address: P010 City: 15j5G,r / State: A ` :-kcf&ress: Zip Code: 3�57S_/ Fax: City: State: Phone No. // �76 7'-6 777 Zip Code: Fax: E-Mail: J7,o l 3 eM, qe6 426 V0 Phone No Fill in fee simple Title Holder on next page(if different •,E-Mail from the Owner listed above) State or-County License if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. i 1 00021111101 AL CONS ION LIE LAW INFO MATt© , DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _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 our Notice of Commencement. Onature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S,C' .1,v c COUNTY OF The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me this C_day of a'n ,20_0 by this day of ,20_ by -'�6 'e b ' 6-lCq ��V\ (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pub"A--State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification of Identification Produced l— � " DEANNA MARIE GIVENS Pr used MY COMMISSION#GG 0221 23 Commission No. p;=( PIRES:December 16,2a Co mission No. (Seal) ,o�F..q.• d Thru Notary Ptbric Unden riters REVIEWS FRONT ZONING J .SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014