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HomeMy WebLinkAboutBuilding Permit Application I ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ Date: OY- Z- Z Z — 7 Permit Number: / C I V D Building Permit Application APR 17 2011 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: To Select from dropbox, click arrow at the end of line i PROPO ED&IIVIPR�OVEMENT,LO;CATION; _ p I F4 P' Address: �d � �nYl J �.n-P- �Prl'.P_ L � S1 Legal Description: Property Tax ID#: 13 '® p / 0 Lot No. Site Plan Name: I Block No. Project Name: Setbacks Front 31. qV Back: (4Z•1 Right Side:--30.77 Left Side: Z2.99 DE�TAI'LED D SCRIPTION�OF WORK: �° < 2 d �rc i'1�►c+b y�a c-I-��e 1 v x Z C) W i 441\ eA 2CA-,r k C 6O1111111 IN U Re,N,ove,d COIVSTRU4CTION I NYFORIVIATIOIV Additional work to e e orme under this permit—check a apply:_ E1HVAC Ei Gas Tank Gas Piping _Shutters a Windows/Doors Electric ❑ Plumbing Sprinklers Generator Roof F71 Roof pitch Total S Ft of Construction: q. � S Ft.of First Floor: Cost of Construction:$ 2 LI OD Utilities. —Sewer[]Septic Building Height: l 2' �OWN;E� R"%L aSSEE ,CO�NTR,,�A,�OR: Name ,mYvt IJ 4Qh e. Q I Q Name: Address: ?- n( P(',v],����re v Company: ,/ ,� J — City: d"� 1'�efGP_ State: (L Address: YIV Zip Code: 3 L) 9 S_) Fax: City: I State: Phone No. 7(1:�—_ <33 —G 9 G Zip Code: Fax: rl E-Mail: CEn 1Ie ©35 Le"i Phone No. Fill in fee simple itle Holder on next page(if different E-Mail: from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. { SUPPLEMENTAL CO'NSTRUCTI©N LIEN LAW INFORMATION: DESIGNER/ENGINEER: / Not Applicable MORTGAGE COMPANY: _Not Applicable Name: i IV �S Name: Address: d. Address: City: l n State F1 City: State: Zip: 394W Phone: 3 Z — Z 12 y 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 coricurrency 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. w�� s Signature of Owner/Lessee/Contractor as Agent for G Signature of Contractor/License Holder ais wH.. STATE OF FLORIDA STATE OF FLORIDA COUNTY OF -;q;"...•; COUNTY OF The fo of g instrtANent was acknowledged before 23- The forgoing instrument was acknowledged before me this ay of 20 E by �o o this_day of 20 _by 9S Z M-< P•y1 py�� eve• � ••�W 7 • 1 i • . �zc (Name of perso acknowledging) mT= (Name of person acknowledging) 'a N 2mm1 Opp j (D v 6:� ,p N ( 1gnature of Not fy,Public-State of r1orlda v (Signature of Notary Public-State of Florida) Personally Known OR Pr ced Ide tification Personally Known OR Produced Identification Type of Identification Produce _�,_ Type of Identification Produced Commission No. (Seal) Commission No. (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS