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HomeMy WebLinkAboutBuilding Permit Application ski i y All APPLICABLE INFO MUST BE COW«fED FOR APPLICATION TO BE ACCEPTEG`- ) 'n Date: Permit Number: . m 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: RDoF R CAAC6^5V T MPO ED HROMEN O fMENT LO ATI©N: Address: 19MO fW,41ni"or—K �ff�JE, ET. 6.46.45t94R45-1— JV 730-' I1 Legal Description: !DDEA1 RCR&eS B 4k /4 10? 00 Property Tax ID#: 3.2/f 8// -0004?-DOO 3 Lot No. O Site Plan Name: H I DA9'71/ 4 CRG.5 Block No. Jq Project Name: Setbacks Front I30 Back:-3 7S Right Side: 31 Left Side:L NN MC- 5 - G f p �{ 9/W0uRow�liw, RE-Alai I DacWwg 4v co be, !/VS-/,*// i'f')F lo U I+iA 9 -r f e-e 1 4 S4i ck u;vc1eJAM ROD FW 4 CON4 R� ON I'NFORa Tl© Additional work to be pertormed under this permit-Check all tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator ---"'Roof 10/4& Pitch Total Sq. Ft of Construction: ''-- 7 754 Sq. Ft.of First Floor: r Cost of Construction:$ 00,9 Utilities: —Sewer —Septic Building Height: OW'NE / Ly tiSE �O R 0 . Name /1//I/ r/� l�"�� Name: Address: Company: City: FT. I0IS-JPCE State: rL Address: Zip Code: -IVF87 Fax: ?W-1/19 t'0 -i 33a City: State: Phone No. 7J - y3I/ Zip Code:. Fax: E-Mail: &AI 1 A1,4• Coy» 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 *+ N5 RWe UMM I "DTIS 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•.m'adeto'obtain,a permit tq 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 Associatidmrules,bylaws or and covenants,that may.restrict ot.prohibit such structure. Please consult with your Home Owners'Association-and'review yourA e'd-for`any restrictions-which may apply: In consideration of the granting of this requested permit,.I do herpby agree.,thaf l viiill;in:all'respects,=per#orrri;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'luses to another:non-residential use WARNJNG 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 recor ' r Notice of Commencement. Signatur 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 11�5_day of ,20a by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) ignature of Notary Public-SUte of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced LASHAHNA INGRAM Produced J`1PaY Pv� Notary Public-State of Florida Commission No. N+ MY Corp;res Dec 20,2016 Commission No. (Seal) Commission#FF 177249 Bonded through National No REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED IL