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HomeMy WebLinkAboutBuilding Permit ApplicationFALL AFte: INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED nn r� Permit Number: to - low Building Permit Application RECOVE® Planning and Development Services Building and Code Regulation Division OCT l 5 2017 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resid t1 9f '`�' - Euci _ . PERMIT APPLICATION FOR: Roof PROPOSED IMPROVEMENT LOCATION." Address: 4o ���e L o t-A P ce tce_ f q- Legal Description: S Q �� L`Jv \ fie �� i� (j Pr` s Property Tax ID #: 3 ©6 "- ©o — ®� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front P 0' Back: P / Right Side: V Ilk Left Side: K) ! A CONSTRUCTION INFO.RMATLON t t un r t is ermit - c ec a a flui iona wor o e e orme e p pp y. [IHVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors 11 Electric 0 Plumbing Sprinklers E Generator 41 Roof R� Roof pitch Total Sq. Ft of Construction: t Z©e) )Z( S . Ft. of First Floor: 2,00 PC Cost of Construction: $ C� I ('000 Utilities: Sewer U Septic Building Height: C' r0 y .OWNER/LESSEE: y T CONTRACTOR. Name troel�_l_ �30� Name: O e.iCk4D ©Qe(1�0 Address:(65`55 FP•FO_�e C+ Company: ©tjeCO;3S"EV_0G4c0&J ! oWetbJj City: _ ®�� pieQC2 fL- State: f�-- Address: A? 66 5W 68A Zip Code:31 q 5 f Fax: iJ l k City: Ym?A 54 l` CA' e- State: F �- Phone No.932 - 266 - 7-01 7 Zip Code: 3 q gt53 Fax: IJ 14 E-Mail: 0 14 Phone No. -13 Z - 2 t-I ® - q `4 q -+ E-Mail:Ot; Cings4ywcc %00 seF2.ukd; &_�1"4.00 o co Fill in fee simple Title Holder on next page (if different from the Owner listed above) State or County License: CCC- ( 33 0 6 Z3 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTfON LIEN LAW INFORMATION ,,. DESIGNER/ENGINEER: of Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: of Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: 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 attorney before commencina work or recording vour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA SE STATE OF FLORIDA _ COUNTY OF COUNTY OF • 1-14—ac The fora instrument was acknowledged before me The forgoing instrument was acknowledged before me this zWday of 0424Z)1450, .2`0 by this _t7ay of 20� by `o�l Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known x­' OR Produced Identification Type of Identification Type of Identification Produced Produced a`'a� P "'•PAtil FTTE BLAIR-ALEXAND (Signature of Notary Public- i ature of Notary Public :iclft)ary Public - State of Flo ,01Y111„ OSPRY PUPA LETTE BLAIR-ALEXAN Commission No. �2' • °i( E S� ry Public _ = Commission # FF 99569 • `- mission No. ��'.'rF FF�OPO,,j�m. Expires Sep 6, 2 - State of FI ��LjlQq� �9 o�c Commission # FF9956 ridalist 9 �•�FOF FI.�P` My Comm. Expires Sep 6, ��.F 020 REVIEWS ,FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17