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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR -APPLICATION TO BE ACCEPTED 171 D p� O 9 Date: r • %% • % 7 Permit Number:RECEIVED • Building !Permit Applicati®OCT 11 2017 a Planning and Development Services Building 0 � and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 • Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential , PERMIT APPLICATION FOR:17 77 P,RO'Pt�S�D IIVIP'ROVEMENT LOCATION. ,: {J; : . Address:' Legal Description: tA►V L T�' Property Tax ID #: ) CI Z _Q O)7 — (`i(7 -� -onn --c�:) Lot No Site Plan Name: Block No. Project Name- Setbacks Front Back: Right Side: Left Side: DETAILED pESRIPTION , S OF WORK21 NVAC. t StJ54I,1L b ILkW 5 °. 1L �-10 �Lv plui,-k .� sr-vjb v3ew P, vv>C e1-laa��e� aNea su it �br_s lJN�� pLV6-��j� Ny (J�c��i KrpD!-l�jo elec4N-z� 3:UV � `� r,IFCr 11N, WeA KVCA`J, �;e).�' e elACNN %N- :-iA"5�C$ vp'Vjeo ApokW�o� Z��29� be40-MVO �taLL ��i'�vS� aoot� At�CI, �Ue� A)zt -1 S � §, `z:-iC(Ae N s � ale ;CONSTRUCTION �NFQMAT RION , _.. ... ... rtiona wor to a pe orme un er t is permit - c ec a t at apply: ; _Vl!(VAC — Gas Tank _ Gas Piping k4utters '6ndow(Doors L/Electric Plumbing Sprinklers _ ^ Generator _ _ Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 6X)Ii �1J�4-Y=—_ Utilities: Sewer Septic _ _ — Building Height: ,.OWNER/LESSEE _' CONTRACTOI•t ' k - " ' Name Z C'LA' Name: CNi`Z ; � Q? Address: `\"3 \\J Ell Company: City: State: �-- Address: Zip CodeFax: City: 9J �`�fJ`� \� C i-� State:�- >>�� r V- Phone NZ 3 — �-t Zip Code: Fax: E-Mail: Phone No. '� �'Z �jy 92 Fill in fee simple Title Holder on next page ( if different E-Mail: < <<io. C ti 'r - , from the Owner listed above) State or &nty License: �1 t r ( a Z ( C_- If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 1 x�....r� u..Y.J._.ix% r. x.......-... .♦ ..�;!�.. .. ..i: ,.. x�lt'Jr,�..kn'S.. ... .x .. :::. r. ,. DESIGNER/ENGINEER: ^Not Applicable --Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable me: F Name• dress: Address: : 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, 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 attome befo y re commencing work or recording our Notice of Commencement. 4VAAc Signat r of Owner Le a Cont s Agent for Owner Signature of Contractor/Lic nse er STATE OF FLORIDA P COUNTY OF lV STATE OF FLORIDA G P COUNTY OF_�y_� � -P The forgoing instrument was acknowledged before me this ltdayofOC bP1r 20by The fing instrument was acknowledged before me this 10*''ayof ©C , 2011 by �IL.7 , Name of erso aking statement Personally Known VOR Name of person �mg statement Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of No _' Zate of Florida) (Signature o u f Commission No. = MA DE LA L�9e PLASCO MMISSION MY COMMISSION 0 GIC�O� Commission WOO 0 GG030398 EXPIRES November 28, 202D REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED tev. 8/2/17