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HomeMy WebLinkAboutBuilding Permit App - William Michael App All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date,;. Permit Number: � ll�� IMIMI Building Permit Application Planning and Development Services Building and Code Regulation Division 2300,i/irginia Avenue,fort Pierce FL 34982 Phone:(772)462.11553 Fax: (772)462-1578 Commercial Residential Address: �QfCU�T14;�flog k Property Tax lD#: �✓ .., (d/ f? �.•�j � Lot No._k Site Flan Name: A+_Rfzll i_ Block No. Proje�t Name: A.tC�A 111 111, 11101 9� aC4 46 Additional work to be performed under this permit—check all that apply: Mechanical _Gas Tank Gas Piping ShuttersWindaws/Daars Electric Plumbing Sprinklers Generator Roof Pitch TotG.'Sq. F`a�C.Onstru;tion: _ _ Sq. Ft. of First Floor: Cost'of Construction: $ Utilities: Sewer Septic Building Height: Na�e Name: Ad6re5 Q ��.- Company:MIA 9 "�tx,`_ _J Pmrir k MA RtP,tfSicfv La ov, City(: I_1�f 5tate:& Address: l'1t� [3 T&rnal4l, Dfy D ZiP'Gade:3_gZ Fax: City (,fh►�� PWA('k' State: Phone No. 2— 577- ©2$ zip code: 3?Mbl Fax: 3a��`T-I`f���a E-i, aii. _ Phone No -7 A- S37" 141'70 _ Fillin fee simple Title Holder on next page( if different E-Mail'9 �`�,S 0 DreU:Sc c6c.n&+ from the Owner listed above) State or County license Q R?yt? If vai`ue of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is 17,500 or more,a RECORDED Notice of Commencement is required. F DES..GNERJENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable �„•.. Name" Name: Add.res: Address: City;_ State: City: State:_ Zip:'` Phone --__—, Zip:._ Phone: FEE'$IMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ^Not Applicable Nance: Name: Add ;pss: -- Address; Cit y ' _ City: - - Zip:: Phone: Zip: Phone: 1A NER/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. t.Luck-_'tro�tlty makes no;epresentation that is granting a permit vviil authorize the permit holder to build the subject structure hick ii;in conflict with any applicable Horne Owners Association rules, bylaws or and covenants that may restrict or prohibit such trurtuire PiPas?consult with your Horne Owners Association and review your deed for any restrictions which may apply.- n con�jtleratiori of the granting of this requested permit,J do hereby agree that I will, in all respects,perform the work n acccieclance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. I he folloWing building permit applications are exempt from undergoing a full concurrency review:room additions, ccaq,,i r,strtic;fztres, sw'.mming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use `WARNING -1.0 OWNER. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR•PAYING '>i•WI"-E Fait tMPROVEMENTS TO FOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDER.AND P01$T ED ON THE JAB SITE (BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT. WITH Yt3ti;R LENDER OR AN ATTORNEY BEFORE RECORDSNG YOUR NOTICE OF COMMENCEMENT." A I A All PA 14, A_'�) JA l Signature of pwner/Lessee/Contractor as Agent for Owner Slgnature of Contractor icense Holder i STATE 3F FLGM'C;'__) STATL OF FLORID COU.N'TY OF-__ COUNTY OF The FirLing Frstri Fer t was acRnowiecig�:d i;efure me t'i',u �o�' wing iristru ent was acknowledged before me this day of_. 20_% this.��._day of 2U by Namjavf person making statement. .� Name of person makin}gg statement, NQr4cji ll y Knowr. _ OR Produced Identification Personally Known /y OR Produced Identification Tyr'!'-' ,i;ioent i" t`:c'. Type of identification Prad i'r€sd..._...._..-__.. _.-...-.._ _ ..._..-- Produc;ed__..._. Vi , (Sign, Wre of fPtary Public-Stat ure of Nota Public-Stat f r' a� Y"y Notary Public State of F oridaY"+�e Notary Public State of Fl ri Comrhlssion No.�L e fgeal shley M Antonelli I rp ! (a o r q y Commission GG 152974 m 'io31 A o�Q `(Sea#ley M Antonelli Hof�a Expires M1812021 y;,, My Commission GG 152)7 a Expires 10f1872U2t REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE. f;F,CEi1[I� DATE. -� COMPLETED >3