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Home My WebLink AboutBuilding Permit Application • ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEDYJ ` Date: ' ! Permit Number: 4 � =❑ E Building Permit Application MAY 10 201,1 Planning and Development Services PERIVAITTING Building and Code Regulation Division St. L cie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSE3 IMPROU Mf,NT LOCATION: Address: !S- Sp-A AV0 V--' dye- -f2�`� ��:2C� �� y� j, Legal Description: Property Tax ID#: ��rL (8 #may©�66Z`C'cS��( Lot No. Site Plan Name: Block No. Project Name:.' Setbacks Front Back: Right Side: Left Side: D' TAILED D"E�S'CRIPTI+� N OF VVORK: p_ 4A- p5z CONSTRUCTIO INFORMATION: Additional work to e nertormed under this permit—check all apply: III ❑HVAC Gas Tank Gas Pi _In-ShuttersWindows Doors []Gas P g ❑ / Electric 0 Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: �b I Cost of Construction:$ CS 00," Utilities: _Sewer Septic Building Height: ®�WNER/LE�SSEE: C®NTRACTOR�: Name• i _ I 1AL5lf;FtL po-'Wt—I Name: Address: z _ Company: Cit Y: ('t" Statet�_L Address: Zip Code: i'f��' Fax: City:' tate: �r Phone No. Zip Code: F E-Mail: 1;w► �k �� 7 00 Phone NO. Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) Sta 11 te or Count icense: If value of construction is$2500 or more,a RECORDED Notice of Commen ment is required. SUPPLEMEaNTAL C®NSTRpl1CTl'QN LIEN-LAW IN`FORMATION.` DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: boo kPoit-1-+r Address: Address: Q Uo Cc - City: State: City:ChA(' r.+ft- State:Nt. Zip: Phone: Zip: ••Ad7 Phone: 27FU5 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 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 commendng wft or recording our Notice of Commencement. ")At/�'' s Signaturb of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA l ' STATE OF FLORIDA COUNTY OF �C• �J�!,� r . COUNTY OF The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me �/ this ( day of Y Y teLt 20 LI by this_day of 20 _by (Name of person ackno ledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produce Identification y/ Personally Known OR Produced Identification Type of Identification Produced IJ Type of Identification Produced Commission No. 7 e _. Commission No. (Seal) ,,, I{f\IZEN S. i`• IFLSER I� :;$Y_-'ca`r My Commission Expu es Revised 07/15/2014 of O, June 12, 201 s qu REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS