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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 5_1q " /7 Permit Number: _ / V1 _ os( / REC @9 ED Building Permit Application MAY 15 2ag Planning and Development Services Building and Code Regulation Division PERMI ING 2300 Virginia Avenue, Fort Pierce FL 34982 St. Luci ounty, FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: // r Address: L& I SE /t%ran je . PL4 ST. 1LecIE, LLE-JL 3LlgO3 Legal Description: %r PO, rk - /,/�%'t L} -� L� � LET h Property Tax ID #: 3y l�q 3d G��//� "OdIJ�S' Lot No.� Site Plan Name: A ndrewJ 5 kcS�Gf&m4e!� Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Zvi s-4 also c� IN CONSTRUCTION INFORMATION: Additional work to e e orme under tispermit-c ec a apply: 11HVAC 11 Gas Tank ❑Gas Piping hutters ❑Windows/Doors Electric ❑ Plumbing Sprinklers LV J Generator 0 Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ —T '�q S Ft. of First Floor: Utilities:0Sewer 0Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name r&tus Name: �a� ,,► a�,,✓cZy^% Address: 14/ l S E !Ubra ✓Ii CI /-H✓e Company: R z ,J L'%t czin " r rye City: �� SS„ LU c i � State: F�L Address: ex elx z 'r Zip Code: 3 14q 23 Fax: City: PS L- Stater/. Phone No. :Zia �- �W -6tgb Zip Code: 34YIS Z Fax: 77,2 335` E-Mail: Phone No. 77 94 5 `747- 1 E-Mail: - M "L '�) e'Z_y".� e )A 6 L j Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License: 456 -©o-el 1 -eYl 1 Z If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: City: Address: 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 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 commencing work or recording your Notice of Commencement. as Agent for Owner STATE OF FLORIDA COUNTY OF S _ L LlGI e The forgoing instrum was acknowledged before me this T day ofav 20 aby of /J ame of person acknowledging) (3ignature of Notary PubliE State of Flo;\`1011 NNE F ilZ7si/ Personally Known OR Produc Ide�Tsi10 Type of Identification Produced a;' January?�•� __�_ Commission No. F� 7(� V,?, �v ; =(Seal '� °°m: c; :' B-'_ 0 4259 s Signature of Contractor/License Holder STATE OF FLORIDA l COUNTY OF S� • -k , The forgoing instrument was acknowledged before me this day of 20 Q_ by (NaNureof ac nowledging ) tary Public - State of FI 'da ) Personally KnownOR Produced Identification T�of Identification Produced Commission No. + (Seal) Revised 07/ 15/2014 r�d��ii SATE OF FI �'�,�~ ° �« p , c M Public •State of Florida `` - NotarY dlF1814iiiil 9� _o;, Y Comm. Expires no _ ��„ ;; ;,,��' fission 7# Ff 177 � REVIEWS FRONT ZONING SUPERVISOR PLANS VEG .. "fON-z_— o g Lf�icna o h COUNTER REVIEW REVIEW REVIEW REVIEW REVf- DROVE .t�iK/ DATE COMPLETE INITIALS