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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE CO�rLtfED FOR APPLICATION TO BE ACCEPTED-" Date: Permit Number: ls�1s - d66�� C PIV ED Building Permit Applicat W4W CPUnty, 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: PRaF'®SED IN�PROII ;�(1/IE T L�CA 1aN: Address: 2-4AU t CJ • Z.." ,q95 Legal Description: �i5o,�' Z3�f I�OZ.- o60-7- Property Tax ID #: ` Lot,No. Site Plan Name: Block No. Project Name: rr Setbacks Front Back: Right Side: LeftSide: 9 DEi'AI'LED DESCRilPTl4N C?� WORK: • , c' � f - ,177 es AJew CC3NSTRl1"CTiON 1NFOR+11lIA + N; ona wor to be per orme un er this permit —c ec .a tat apply: Mechanical _ Gas Tank _ Gas Piping .'Shutters (/ Windows/Doors Electric VP I u m b i n"g .: Sprinklers _ Generator VRoof ` Pitch _ Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ IUD J%1i Utilities: —Sewer Aseptic Building Height: E 'Mill I Name- SAME � Name Ajxdar Au4LA.3v 6AD L Address: Co S• ZH�� (Or Company: s. 1K City: si 14s.w Aeke State: V Address; , n ! State: City: Zip Code: Fax: Phone No. 1!;�© Al 4°5 &10�/ Zip Code: _ Fax: E-Mail: 'Ati-l-ka-mv re otJVd.'C4M, Phone No_ L' Fill in fee simple Title Holder on next page (if di erent E-Mail ll State or.'Gourity, License from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commericemerit is .required. .. �. �tJP ''L � ENTAL CONS � Q'N INN IN��UR� AT 0Ni _ . , DESIGNER/ENGINEER: _ Name: 65As, -.: aVS0— Address Ito' City: 5eA L-JAI(f,o� Zip: Co. Phone772- Not Applicable `~State: F'l• �:�7S5 MORTGAGE COMPANY: Name: i o o� Address: Ss 50. re City: U Zip: "Phone:77L• _ NAt Applicable 30/ State:_ Z 6(oi FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Address: Name: 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, bylawsor and.covenants,that may restrict,or prohibit such structu''re. 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 ma result in your paying twice for improvements to your property. A Notice of Commencement must be rec rded and posted on the jobsite before the first in pection. If you intend to obtain financing, consult ith I rider or an attorney before commencillyor or recording our Notice of Commencement. Sig "tu er/ Lessee/Contractor as Agent -for Owner' . -STATE OF FLORIDA . . 'COUNTY OFF The forgoing instrument was acknowledged me this Zf(-day of 20 Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced l, (Signa ure of Notary Public- St of F orida) ' Commission No. "' (S ,�•,,,, E� STAT F FLORIDA 'COt)N F The forgoing instrNen this day of Name of person making icense Holder was acknowledged before me 20_ by Personally Known OR Produced la' Type of Identification Produced (Signature of Notary Public- State of Florida ) Commission No: (Seal)' " REVIEWS FRONT ZONINGF3— SOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEWJKS14UR REVIEW REVIEW REVIEW REVIEW DATE a�sil8,DATECOMPLETED RECEIVED Kev. u/211 W;7. \ I . CD'` 0 co y ., Q 0