HomeMy WebLinkAbout1705-0562 BUILDING PERMIT APPLICATIONALL APPLIC/ABLEl INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Lim � /� Date: /� % (/ / Permit Number: Lim l &0 a -- Building Permit Application C Planning and Development Services Z 5 `t011 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 �TT1NG FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential county' PERMIT APPLICATION FOR Address: Legal Description: Property Tax ID #: 4ov To Select from dropbox, click arrow at the end of line OCATIO:N UJ - rn 16 w A-Y ►24.) (Ds ,�_ -3R 9 7 Dices Lot No.-.14 Site Plan Name: AI41fl- Block No. Project Name: &b Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK B vim cps 16A4�R�! rRv F-Sim%-��L �,00� 0 J- rlF� �i✓c#;iF S'W -:CONSTRUCTION INf:ORMATION Additional work to je ne orme under this permit - check a apply: 171 L_ HVAC _I Gas Tank ❑Gas Piping _ Shutters Windows/Doors FUT Electric Plumbing O Sprinklers E Generator 12 Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ _3Qmo Utilities: Sewer 10 Septic Building Height: - 1 OWNER'/.LESSEE ,' 6 CONTRACTOR Nameg aM 4 6 - �,p Name: Address: AI v. Company: GG7� l9/. G- City: State- Address: k m /cam J� . Zip Code: Fax: City: /� State: Phone No. �f ,3A' 224 I 7_� nX , Zip Code,-!y?,'<'3 E-Mail: �Fax: Phone No. `Z�A� E-Mail: f Ci6K1%Le / C �q��'/� / GB Fill in fee simple Title Holder on next page (if different from the Owner listed above) State or County License:(�G It value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEEm_ Not Applicable MORTGAGE COMPANY: Not Applicable R Nae: G -C © G Ci Name: Address: .,!}) /� = Address: City:, o State: , City: State: Zip: It4cfCrP Phone: — Zip: Phone: FEE SIMPLE TITLE HOLDER: 7y— Not Applicable Name: Address: City: Zip: Phone: BONDING COMPANY: [Not Applicable Name: Address: City: 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 vour Notice of Commencement. s Signature w /Lessee/Contractor as Agent for Owner Signaturet6f ontractor/license Holder STATE OF FLORIDA STATE OF FLORIDA�,�, COUNTY OF� !JG/I:' COUNTY OF ii/� L a. The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me this_ day of M 20 11by this _Sday of V*�_P20 \9 by (Name of per n acknowledging) (Name of pers n acknowledging ) (Signature of1botary Public- State of Florida) (Signature of Jotary Public- State of Florida ) Personally Known V O P o uced Ldentifcati1�11on Personally Known ll OR Produced Identification Type of I fca/ytiiot�nP^yronuc ti,nav Anip unnn yp of Identification Produced-_, VW`�-C ♦\1P�1-F('C��. \\11111IIi Notary Public • State of Florida a� MARY ANN HOOD Commission No. =• ° `.(Seaeommission # FF 2022 �o mission No.T� * NJf Pklbllc - State of Florida My Comm. Expires Mar 17, 2019 �* •�, Commission # FF 202265 o.. A.Ath--hK1,11—aINrd Acsn '�:2 co�•� MY COMM- FYOIrPc AAA 47 n— Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE I 11 INITIALS