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HomeMy WebLinkAboutBuilding permit application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 0 O 1"(33d0 -___,�._� RECEIVED JAN 177.��7 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 OUEMIENT L®C Address: I ' I/ Legal Description: ,4 J_- 6 L-K- LCT2 Property Tax ID#: Ia)?-"ejr-)-r)i( Ll- It o Lot No.2 1 G Site Plan Name: 7 6 •e Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE SC•RIPTION OF WORK �� _ recce ex�� ��ncJle ��K► -ILOqC( tv Cx'IvMP ova tc F Y)eVr- �Cd Xv . CONSTFtIJCTION 1=©.RMATI®'N rt � - Additional work to be pertormea under this permit-check all tat apply: _HVAC _Gas Tank —Gas Piping _Shutters endows/Doors _Electric _Plumbing _Sprinklers _Generator v Roof 1L Roof pitch Total Sq. Ft of Construction:: 15 I � O g� Sq. Ft.of First Floor: L A6 Cost of Construction:$ A j 230.(DO Utilities: —Sewer —Septic Building Height: OWNER/LE=�S5'EE: sCONTRACT®R �, ?. : emu__ Nam Name: Address: Company: t City:Fr P 1 State: • Address�gl2 �LLa(�('C�J 13Ue, Zip Code: °JI Fax: City:�CJ t ��� Stater Phone No. Zip Code:S I"9-44 Fax: E-Mail: Phone No.::TD2 Lp-.- q -ICOL03 Fill in fee simple Title Holder on next page(if different E-Mail:�0 i te—_Y- St V-)P,GZd M from the Owner listed above) State or County License: C C L 135 03,9'7 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. • SU RUMENT�LCONSTRUCTIt�tV Lt'EN LgW INFORMFrTtON�# r N k;..r'2J.+ ..-.. -.,. ,�, ,a11a,�, x y5 x 2,.•t,�'' 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: 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. -- s Signature of wner/Lessee/Contractor as Agent for Owner ignature ofc6nt e o der STATE OF FLORIDA STATE OF FLORIDA COUNTY OF YVt-,At v1 COUNTY OF 600472 The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this l'4- day of �a vn 20 Eby this 19- day of a0GV) 20 L�L by yrc"40 (Name of pets n acknowledging) (Name of perso acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known _OR Produced Identification PersonallyKnown k OR Produced Identification Type of Identificatiofi Produced Type of IdentificatioK Produced Commission No. :�• FM4 oa ) Srry , TNERESADERITA a tileY.�F''• THERESADERITA MY COMMISSION#FF 06292 MY COMMISSION#FF 062929 : _c o er z r a= : cto er29,2017 Revised 07/15/2014 Bonded Thru Notary Public Underwriters i .#�f Bonded Thor Notary Public Underw hers REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS