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HomeMy WebLinkAboutBuilding Permit Application *. ALL,APPLICABLE INFO MUST BE COMPIOD FOR APPLICATION TO.BE ACCEPTED t Date: Permit Number: 13 t t1 RACE{'�`�� �.'-:; 0 3 Z� • Building Permit Application Panning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 3498,2 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: ��,na J d, •,a PROPOSED IIV PRO 'EfYtENT LDCATfQN Address: Legal Description: 0 Property Tax ID#:' 01�5 6f„ q 35 b��® T Lot No. Site Plan Name Block No. 2 Project Name: Setbacks Front_ Back: Right Side: Left Side DETAILED DESCiIPTION C)F WORK,_ -� 1. ,►-� �o d©��L 014STRUCT1dN: 1NF O MAT1 N �t�ona wor to a pe; orme under this permit-cnecK all that apply: HVAC —Gas Tank —Gas Piping ^Shutters Windows/Doors Electric Plumbing _Sprinklers _Generator _ Roof Roof pitch Total Sq.Ft of Construction: Sq. Ft.of First Floor: Cost of Construction;$ Utilities: —Sewer —Septic Building Height: Name L„ rl= t,3 Name: 0 k"�b = VJ t Address: Company: \ (T City: State, Address: le cok -el Zip Co e: Fax: City: ` C State: L Phone No.(?t�ll �I^ Zip Code:�? �� Fax: E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: l [� a W&t from the Owner listed above) State or County License: �o�C ���_ F F:202 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENT-NI CONSTRUCTION LIEN LAIN 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: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: 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 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 GINNER: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. s Signature o wner/Lesse ontfb s Agent for Owner Signatu of Contractor/ cen STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Li p COUNTY OF Ivy ��t ? The forging instru Went was acknowledged before me The for instrument was acknowledged before me this day of 20 Eby this day of Icy .20 f+ by (Name of person ac owledging) (Name of person a knowledging) 160�1/ (Signature of Notary Pu "c-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced de"V MAD LnhUZ VELASCO MA DE LA LL�(L�IPZ�� ELASCO Commission No._ •� My CO SSION 0 GG050399 Commission No. ' COMMISSTON GG030399 EXPIRES November 28.2020 EXPIRES November 28,2020 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLAA VEGETATION SEATURTLE MANGROVE COIJNTER REVIEW REVIEW REVI R E Vj.,FW REVIEW REVIEW DATE I COMPLETE INITIALS