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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLET`ru' OR APPLICATION TO BE ACCEPT Date: 16\-6 Permit Number: RECEIVED 11, .,. Building Permit A plIcatio Planning and Development Services pR 3 0 2017 Building and Code Regulation Division artment 2300 Virginia Avenue, Fort Pierce FL 34982 Permitting Department FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial �sld i�a�OUt=— PERMIT APPLICATION FOR: PR:OP,OSED IN`PROVEMENT LOCATION: Address: Si +�^'f1�1 ��1ZrtgNF�rJ W cS+^ Agars i-l- 2K5 Ste, Legal Description: 5; - L-Je-%! 4,b 3.6 L-t C3Lys \ At►_r�'. L`fS- f-L-( C�rz vs-I;t -z- C%l W LFss rtQ CLSf W Awn 1-xc.s As irj occs 2�53< a`-�Z Property Tax ID #: 3 ,Lk k1-k - Sn1 - t-74i - dno --J Lot No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Pr [� �.N LEAy6 c= (2 o u. A IvM%N--� C C F QV r-- ditional work to be pertormed under this permit- cnec _Mechanical _ Gas Tank _ Gas Piping Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: \-1 (..H Block No. appiy: Shutters _ Windows/Doors _ Generator _ Roof Sq. Ft. of First Floor: Cost of Construction: $ 1:�) Utilities: —Sewer —Septic Building Height: Name L:a vs V) Address:S 7 City: s-r - L.x-I� Stater Zip Code: 3y"1_S'a_ Fax: Phone No. E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) ' Name: - rZSoh,,v4 Company: 0te S 9 22--ic.-_ Address: ci►kx 51..E -,X, City: P D t-\P AN© c3 fie! 7 State: r-L— Zip Code: '3 3 c,G0i Fax: Phone No gv o -_-A2.r, -- 6677 E-Mail State or County License Cr-L_ot-1��5�`) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SU�PPLE�+E TA CO�NSTRIJ TION LIEN 'LAIN I'N - ORIVtATION DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: > Not Applicable Name: aA-nr>rs _-6���., vas£ Name: Addresss,:; i5so` ri::�,/AN:o Ewt. A -Az_ x—an Address: City: CIL- ? ..r -' i�v�. 4' ti State: City: State•:r Zip: 33e;f_-� Pliorie' Zip: Phone: FEE SIMPLE TITLEHOLDER--,-;' _ NofApplicable BONDING COMPANY: Not Applicable Name: Address:f96;�o"vs` a=i' c-i`ui 2 Address: City: c;� 's-�'-{'y��"- I City: Zip: Phone: Zip: Ph -one:- - — - I 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 commence 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 pelrmit, 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,Isigns, 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. I you intend to obtain financing, consult with lender or an attorney before commencing work or rgie6rding your Notice of Commencement. Signature' " ne essee/Co to or as Agent fo Owner tgn ure or/License Holder ZRIDA STATE OF FLORIDA STATE OF FL _ =_ . COUNTY OF �3 ®\,•��A rc p COUNTY OF Q �?©�,� A rLIS The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this �)Lgo day of 20A�2 by I this ,:�_O day of a—'ToG , 20A by •. (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- State of Florida) I (Signature of Notary Public- State of Florida ) Personally Known =— OR Produced Identification Personally Known OR Produced Identification Type of Identification ALANMILLEn Type of Identification °`""�Pb�� ALANMILLER Produced * MY COMMISSION # FF 195499 Produced MY COMMISSION # FF 195499 EXPIRE $: May 5, 2019 EXPIRES: May 5, 2019 ''rF�F�Oa�O Commission No. '-''OF (cBandedThruBudgetNotaryServices Commission No. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. //21014