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HomeMy WebLinkAboutBuilding Permit Applicationf X _ ALL APPLICABLE INFO M ST BE COMPLETED FOR APPLICATION TO -BE -ACCEPTED ,-Li ,.. Date: © Permit Number:�� Building Permit Application 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 X Residential PERMIT APPLICATION FOR: To Se ec from dr p ox, c rck ar oW at the end of Ilne Address: Legal Description: Property Tax ID #: l / nl C;Q0 - 000 ff - 000 f Site Plan Name: Project Name: fJ(-0 L M Setbacks Front- 9/ Back:Right Side: Left Side: r Cow sr/ZaC-e-To^l o IC A A(eW rR0Ot7" 12 ieR &?U S' � poi ���S �7 � � r�.� �� TjGr I L►� i^;e 6 Lot No._ r Rl�r�• II CO-' ©11 Addi�ti nal work to be ertormed under this permit - cnecK all that apply: W HVAC Gas Tank ❑Gas Piping ILJI Shutters Windows/Doors _ Electric El Plumbing Oprinklers 1:1 Generator 9-Roof Total Sq. Ft of Construction* SF S . Ft. of First Floor: /50 SF Cost of Construction: $ CD Utilities:Sewer O Septic Building Height: ice® >f7-7 go Name -7,0, �' ��►,� �rzu5T 4;.! J.0 Address: 3100 sLVO City: State: �L Zip Code: 3��-3, %� Fax: Phone No. �� 5- E-Mail: Fill in fee simple Title Holder on next page ( if different from the owner listed above) Name: Ft t HikfLb C . AtE 2"9NS Company: AtklzrgS Address: 14(.( kl 1"Tl C✓ City: (Aloe .p K65— State: FLA- Zip Code: 33qtZ Fax50(-0163-%97 Phone No. '561—cg 3- 966 L E-Mail:ya%r-e1NS r?yks C6O�i iKt State or County License: C 18e 06ti5 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. Roo s •�� �,�.e Al e _A DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Name: �lr'UEIvS Go flE�li 3 Name: Address: Add'ress: City: State City: Zip:334(o A Phone: SWOO S; Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: Not Applicable State: BONDING COMPANY: 4Not Applicable Name: Address: City: 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 commencinlz work or recordine vour Notice of Commencement. Signature of 0t r/ Agent/ Lessee STATE OF FLORI COUNTY OF , I�'Ld C_.) The for g)ng instru inent was acknowledged before me thisq�/ may of 20 14 by cra"'!:)i (Name of perasoj acknowZiL 9- Q (Sifna7e of Notary u lic- State of Florida ) Personally Known W__"'OR Produced Identification Type of Identification Produced CommJss"J)n ',k%,= NotaryPublic Stete of Fldftal) oa_ My Commission EE115646 L' Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF k,nrN (�eoocc-1 The forgoing instrument was acknowledged before me this.2bday of_CCAX Dee ,20 14 by (Name of person acknowledging) (Signature of Notary Public- State of Personally Knowny Type of Identification Commission No. MY COMMISSION N FF 049994 EXPdt3gS eptember21, 2017 Bond m tary Public Undenr bm REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE U COMPLETE �/ INITIALS // &