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HomeMy WebLinkAboutBuilding Permit Applicationn All APPLICABLE INFO MUST BE COMPLET,�__-,'OR APPLICATION TO BE ACCEPTED Date: O Permit Number: q \0 - RECEIVE-D OCT 2 0 2017 Building Permit Application Planning and Developmen'tktuic - 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: 06 �. _ mQ�- 1 Address: Legal Description Legal Description:_ WIND'1BLLVILLAGEBYTHESEALRJITIlVpBEGATSECORBLRB,THRUNNO011EGMABNlOSECN 38 SECE2609 '; TRH gY C�UBVE COVC SIy�LY, RlS Fr CA49 DEG 4�3MIN 166SEC RUPj $�pyyN,�{,C C3D3MW ,F1', TERQ 89 DEG 56 AtRJ i� SEC E 8240 Fr TO 1'OB (OR 3692-000) Property Tax ID #: Lot No. Site Plan Name: A(6ve— Block No. Project Name: CL� t I ► t Setbacks Front Back: Right Side: Left Side: (e5 - _Mechanical _ Gas Tank —Gas Piping _ Electric , Plumbing _ Sprinklers Total Sq. Ft of Construction: - a -7d0 Cost of Construction: $ (� ��©� • fib '� &A •Code: Phone • / ►• all tnat apply: _ Shutters _ Generator Sq. Ft. of First Floor: _ Windows/Doors Roof Pitch Utilities:. —Sewer —Septic Building Height: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name:_ Company: City: Zip Code: �j �'f Fax: Phone No E-Mail IV V State or County License (2 CC- If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: - 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 Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants that may restgct 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 tt�e 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 additiohs, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-rdidential 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 recordin"our Notice of Commencement. of Owner/ Lessee/CorgffaCtor as Agent for Owner I Signature of STATE OF FLORIDA STATE OF FLORIDA COUNTY OFF 1 r, v l COUNTY OF /! 1 The forg ing instrument vyas acknowledged before me this Mday of Ct20 by (Signature of Notary7P--u"6ifc-tateof Frohda j Personally Known lProduced Identification Type of Identification Produced Commission No. (Seal) The forgoing instrum t was acknowledged before me this 7� of. ,20`7by Ao&—C�Ag:5 (Name of person acknowledging) of Personally Known l / OR Produced Identification Type of Identification Produced Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETE ,W .I'IERAb1r%JiAkJCC0AkARfoNKIERAN DILIA3 FRAMPTON ev. MY COMMISSION # GG107538 ='t ;c MY COMMISSION # GG107538 EXPIRES May 23, 2021 EXPIRES May 23, 2021