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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 1' CJ(,0 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 Select from dropbox, click arrow at the end of line PRO,POSED:I"IVIPROVEMENT �OCATIQ.N Address: 4S50 S • ©C e a,(\ ,bc.. _ I4 1 I0D ! �lr'1 3 evlse1�- 2cLCh �8... • '� y 5`I Legal Description: S,�lQnAia S Cameo 0,n 14- 11D3 3 M2 - 113+ Property Tax ID #: 4 s,)a-(e0I wy1. oco —O Lot No.U�• — Site Plan Name: Block No. Project Name:T_-InhAlzt% �f:7 Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION.OF WORK CONSTRUCTION INFORMATION �. Additional work to e e orme under this permit — check a apply: EIHVAC Ei Gas Tank ❑Gas Piping Shutters FY]Windows/Doors 11 Electric El_ Plumbing Sprinklers Generator _ Roof Roof pitch Total Sq. Ft of Construction: @ S Ft. of First Floor: Cost of Construction: $ -A I . i _ (� U Utilities:li Sewer []Septic Building Height: OWNER/LESSEE CONTRACT013: Name Address: Qc.e[in , r o br. Name:t�cAtx,ral T10tA3 Company: aY1-f_t M Address: 3 J 1 tj F_ _Bcik_e,( T.nc. Ilic-i ,C oc1 cA City: .J 3e1(1^ 2Ci L1/1 State: FL Zip Code: 61 Fax: City: 4y+uaC-A State:Fi! Phone No. 'I "la - 2.2. Zip Code: 3y 9 15 4 Phone No. Fax.—A1a-334 '--t o-B E-Mail: ,( �ct C AU . Y% Fill in fee limp -lie Title Holder on next page ( if different E-Mail: A State or ounty License: 50C,15115'12-63 from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 11E SUPPLEMENTAL CONSTRUCT10 LIEN LAIN IN1='URMATION` ` NE DESIGNER/ENGINEER: _ Not Applicable a.s< MORTGAGE COMPANY: Not Applicable Name: Name: _ Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Applicable Name: Name: _Not 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 reviewyour 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,, acce'ssory'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 your Notice of Commencement. Signatur=RIDA r/Lessee/Contractor as Agent for Owner STATE COUNTY OFt The for ping instrument was,acknowledged before me this _nday of 20 n by (Name of pers acknowledging) ( \ n Notary Public- State-mf Florida ) Personally Known OR Produced Identification " Type of Identification Produced Commission No. (Seal) C s Signa re o Contractor/License Holder. ST T d FLOR A\ COUNTY OF t�i�ote . The forgoing instrument was acknowledge before me this day of 20 `! by lam` (Name of erson acknowledging) of Notary PublidQ)State of Florida ) Personally Known OR Produced Identification Typ f Identification Produce,' Commission;No. .. — Gr,,M) ,.n'r'r'ua,, LASHAHNA INGRAM �O1je a col���= Notary Public - State. z°*�`� Notary Public - State of Florida n ; �; °-` My Comm. Expires Dec 20, 2018 Revised 07/15/201 ' y P M Comm. Expires Dec 20, 2018 AA Commission # FF 177249 ' r nmmicsinn 4A FF 1 " " " Bonded thrnunh Nafi l AIN.,.,. A....- 5 __................ through Na .. .. ... .. .. ional Notary Assn.REVIEWS ,.__ _- _ 1-41 mall.Bonded FRONTT�%�'— ONINGSUPERVISOR PLANS VEGETATISEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEWREVIEW REVIEW DATE I COMPLETE INITIALS