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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST / BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 05- /' I Permit Number: ."'°'y h h ; :t ;RECEIVED 1011 - Building Permit Application Planning and Development Services PurritLucleDComment ounty Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial, - Residential PERMITTYPE: A1 -0 j 1-J 0 Address: I [3'IF_STtC. WAY Property Tax ID #: I y ly - 701 -01 ? 1 -co_,o?- S Lot No. Site Plan Name: W-12CnO L-A QeP Vda-tL-5 Block No. Project Name: 1,Ler<,J I=124-,?t T' et"ce- Additional work to be performed under this permit - check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: ` Cost of Construction: $ I, 4 ou tti Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: . ���•II��V..�Ifi421fit{ y'`.'+.aq'•Rt i :.. .. a`"1. T'Y�..M ,�+_©�'f'T-C h4.1TK' E ..�_.k. .. 3. G-f �M1M1.4 T }Gk Name TA1I%e.5 A !t C2C42W4:�,tL13C 1AL'064zi Company: Address: IS ��i�5'�iSj �G �u��/ City: ' F . FICUtIE _ Al. State: -E�-• Zip Code: 3 q q_ Fax: L*� Phone No. �,j y - z1+ y!5-5�j Address: City: State: Zip Code: Fax: Phone No E-Mail: huc) -3 v�Q (2, 4o(,, . Corn Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail State or County License If value of construction is 52500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. ft"wil LE "e••''•9i3•p�NRa� s'i�.h'�yS"�,y5p-y'_�w�•' .r S�-.'•:k DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: of Applicable Name: OA%& PIA Name: K0-,Xh-ePL,iG Address: 351 GY `_S I �G 3t 20 .&,1%Lf Address: _ City: Tomto4i► o a" State: Ft— City: State: Zip: 33060 Phone R Z;,4 — TJ 3 —0487 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _ of Applicable Name:_J'A%1GS A 4 7A1it1C. PfJW+iLyi,rl{sW Name: Address: 1 CSTIc� eu, Address: City: ff. L`tZ��� FL.. City: Zip: 3N.d1149 Phone: 4ff" !- Z1W_L1!M3 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 l e(eby.agree that I will; iri a -II 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, screeh°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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER "OR •AN A' EY BEFORE RECORDING YOUR -NOTICE OF COMMENCEMENT-". Signature oor as gent for Owner Signature of Contractor/License Holder STATE OF STATE OF FLORIDA COUNTY -gal �P� COUNTY OF The f r ing instr� e t was acknowledged before me The forgoing instrument was acknowledged before me this "day of , 20� by this day of 20_ by a1weC W)6)-)re— . - Name of person making stateirient. Name of person making statement. Personally Known OR Produced Identification Personally Known .. • OR Produced Identification Type of ldenti44cption T e of Identification Type Produced (. Produced (Signature of Notary _ (Signature of Notary.Public-.State of Florida):', AUDREY B. HUMPHREY Commission No. 2` '�, MYC(01aMISSION#GG330817 Commission No. `(Seal) . EXPIRES: March 6, 2U23 "00 Bonded Thru NotaPLIPublic Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION . SEA TURTLE. .MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/ //1y