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HomeMy WebLinkAboutBuilding Permit Application MP All APPLICABLE INFO MUST BE CO FETED FOR APPLICATION TO BE ACCEPTE Date: �I I I I I Permit Number: w �q N � a. i r e 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: P'ROP®S,ED IN�PROUEMENT LOCATItU Address: S 7rgc,f- PS � --4-( 3HqFs_,:�_) { Legal Description: J V-er r - LAn ) 3- 1 L N Ln 31 tmkp I yorl 1500 Property Tax ID#: 013(-v ,7:: p©_ Lot No. 31 Site Plan Name: Block No. L� Project Name: Setbacks Front Back: Right Side: Left Side: ®ETAII.E® DEASCRIPTI;ON rLeMoV< f4S+n4 rooF SIIS41Q ds—n IS) 121lk�. i2e -MIA,: l b r��12. . l �S1�l1 ,O�eI ►� S}iClc LA 0 . k?S4g It .-,,9(.P G,a 5,2V m 1 L- 60113l' row owl C®NSTRl1CTlON 1lNF®RaMATIiQ'N: --------- Additional work to be pe orme un er this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator 1 Roof Total Sq. Ft of Construction: I Sq. Ft.of First Floor: Cost of Construction:$ Utilities: —Sewer —Septic Building Height: [ OWNER LE�SSE:- CONTRA T®R: Name t011l o JA egC, ((P Name: e � �Y� �Y1 Address:-35Lo0' (wff SS 51- _ Company: �(—(- City: 126051 State:74k Address:1�l h 310 S AOtd S14 vv Zip Code: :5111 �3 Fax: City:PS L_ State:y e Phone No. Lp oZ ( r1 Zip Code: 3L1qT_1 Fax: rl' rl 7, SSli E-Mail:\�+�s @ j Sland�rr, r�;�s h�rhgmaS.Ciw, Phone No r)gc) 3 L4+ 91 1 J Fill in fee simple Title Holder on next page (if different E-Mailer Lucy (f 0�'41n� 4 o-jioo.C0r-1 from the Owner listed above) State or County License ecc if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENT @®NSTRIJCT`I`fJN LIE LAW IN'F®RMAl`If+N: 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: r Address: City: City: Zip: Phone: 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 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. Signatu o Owner/Lessee/Agent Signature of Co ractor/License Holder STATE OF FLORIDA STATE OF FLORIDP, COUNTY OF Lu COUNTY OF �t . LLf.0 The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this I day of '"I 20 by this I day of P'16+" 20 17 by e F � 44Orn Sal ►arm S� (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of NotaPublic-State of Florida) Personal) Known�P d I e sonall Known �,4 rocl t """'! Y I 7l IS TC PF2t�!! Y �f� � �� Type of Identification ` �.�= e of Identification _ = MY COMMISSION#FF 16 �� = MY COMMISSION#FF 160517 Produced EXPIRES September 16,2 Er duced c September 16,2018 407 3!"153 Fbndallotaryservice.com ] 0 (40 d8-0153 Floor aNata 'J.., = Commission No. 1 �u �� ea ommission No.l , REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED 7 DATE COMPLETED ev. 7/2014