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HomeMy WebLinkAboutBuilding Permit Application 'I All APPLICA E I FO MUST BE COMPLET D FOR APPLICATION TO BE ACCEPTED Date: d.511"� Permit Number: V1 1u 6 51 y I RECEI\.`�-.D APR 25 2017 ' ., 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: PROROSED INRPROVEMENl' L®CATI`a'N: Address: Legal Description: 1JW Co YA 14 O "r f, ©p- ` TC1- I? 3E� '' LL Property Tax ID#: ��� -"lZ2 '� ® -- I� Lot No. Site Plan Name: ?,-FJA % Ll_ -iV� Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ®ETAILED DE�SCRIPTt.®N F VNORK: oLie B CONSTRUCTION 1NF®RMBTION: iti orkt6bepertormed 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: 1e:Q0 SF Sq. Ft. of First Floor: Cost of Construction: $ OS Utilities: —Sewer _Septic Building Height: ' I OTIINER/ C EL ITI,CTIO,R: Name IL:L.E Name: Address: 402 `� I M W6CC :J Company:: ( City: 1' 1 g i L-,3 Cr145 State:f Address:-( ( SE7 B66<1 f-i Zip Code: Fax: City: poax- 2x-- L-0(-t o State: Phone No. —7-7?-_ 52-g i LA(ygG Zip Code: SLt.C152. Fax- E-Mail: /iir lSSy i) 7 Q-k�10T11r1141 L. CVM Phone No "2 3i-['Z- 2S'%-( Fill in fee simple Title Holderlon next page(if different 'E-Mail 1+PCS'f -rtY1 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 SIJPPLE�IViEN AL CaNSTRUCTI®N LIEN I�IN IIN;F®R11/IA1"ION: DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applic le Name: D Name: Address: .G Address: City: 0'ecL__ State: � City: State: Zip: 2a� - Phone `kp0 A '3ip� 0-2-ct2.._. Zip Ph e: FEE SIMPLE TITLE HOLD _Not Applicabl BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: r Phone• Zip: Pho OWNER/CONT TOR 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 con-irrikencing work or_recording our Notice of Commencement. Signature f dwne es a ontractor.as Agen Owner Signature of Lic se Holder STATE OF FLORIDA STATE OF FLORIDA , COUNTY OF 63C. COUNTY OF SAP- "CA The forgoing instrument was acknowledg before me The for oing instrument was acknowledged before me this�.S day of C\ 20 by this 3a1 day of_C\ \ 20A3— by �a •C �y ��'iag1�� �ati� �,t�a���e.�g (Name of person acknowle Bing) (Name of person acknowle ging) 1 (Signature of Notary blic-State of Florida) (Signature of Notary P blic-State of Florida ) Personally Known OR Produced Identification Personally Known _ Type of Identification Produced __— -- Type of Identific i ,•��o;•.,, DEANNAMARIE GMENS �-- '-- ,, �..._IEGNENS c ' DEANN.AMAR Produced - MY COMMISSION#L•':Stl';':�r9 MY GOt4P,71SS40N#GG U22023 .a EXPIRES:December iG;",I Commission No. ��b - o�B ��p,� Decal- mber16,2020 Commission No. `.� 'L�p onded ihruNota ff ��Ohru�Decal—uc 1-4—stars . o Bonded� i REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW. REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.