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HomeMy WebLinkAboutBuilding Permit Application i v ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: " l� Permit Number: -1 J RECEI':�D MAR q 2 2011 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 p V c Wo :RROPOSED IMPROVEMENT-' (OC TI , Address: lltn 's s C)LZRO _W�-, A las Legal Description: Property Tax ID#: 511 " 80 1 O 3%S-7 `Q bb-to Lot No. Site Plan Name: Block No. Project Name: �15Ti �dl�-A Setbacks Front Back: Right Side: Left Side: DETAILED bESCRIPTION OF WOR1< y b.4cJ 0A CONSTRUCTION INFORIUTATIO'N -, y A. fna wor to e e orme under this permit-check a t appy: iti —9HVAC Gas Tank []Gas Piping —Shutters .�❑Windows/Doors r ❑Electric ❑Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: o� Cost-of Construction: $ Jam, Cabo Utilities: Sewer[]Septic Building Height: j OWNER/LESSEE CONTRACTOR y Name 1GL I-�OQU� I Name: i�P RQ_eta 7i�,2 j Address: �5 S tSC+eAtiI l�r2 I d� Company: "tcAl lun I i City: kL k-C_VAtv.1Son1 -_J�SlahSJ State: Address:Nt> _14pA,"_ Pc: K C]2 Zip Code: ­94qq ,l Fax: - City:-;�'"PaLeA State:. Phone No. 5(ot- 3©8- 51s3 Zip Code:-3A, 33 �, _ Fax9$4-i748 5`Zg i E-Mail: Phone No.�rJ�`7h ���� `�La/J7 Fill in fee simple Title Holder on next page (if different E-Mail--_B535 IlUbl & C6Mh =R4- wi�t from the Owner listed above) I State or County License: CAA' if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: — Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: I/ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: I 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 thepermit 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,Aie first inspection. If you intend to obtain financing, con with lender or an attorney before com en ing work or re ding oy ur Notice of Commencemen . �i�--- s Si nat of wner/L se ntractor as Agent for Owner Si re o tontralrqtorLicense Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF _ Lo ,CI COUNTY OF Sb- �., ci The forgoing insti;uum nt was acknowledged before me The forgoing instrument was acknowledged before me this day of i C' UA r� 20 +'1 by this 0 0°(day of ©CUGI� 20 Q_by 6k t M `�C lr vo (Name of person ackn wledging) (Name of person acknowl ging) C ott— (Signature of Notary ub•c-State o lorida) (Signature of No ary Public-State of Florida) Personally Known OR Produced-Identification Person � on Type of d ti ' Type of e n rodL%WSA LV*Nlow �� MILM L"M -- Notary Public='rte Commis o Notu Public•no� Commi •= Commission i(i8 •_ Cpmmisslon M AG rf y omm. 108&Oct ` •; Comm.Expires Oct 12,2020 ,u'�•° Bondi dlbfo*NMl6pflNllalryApo Bonded through WHO=Maly Revised 07/15/26'# REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS