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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COIVIPLETECi-FOR APPLICATION TO BE ACCEP Eu Date: �' Z Permit Number: SCANNED BY RECEIVED St Lucie County FEB 07 1010 Building Permit Application Planningand Development Services Per i t'n Department p ,��i��sOM Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: CfinL�% }- � Legal Description: -31 a Lfil/f%S� �4J1�Si�e�JIU Jt�� 5 �/-5 /mot F/ � s u -6 rty�Tax1!Q�#: a / 2_ 9 - 7dLot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side:" !2- B Left Side: '/ : l� DETAILED DESCRIP ,. CIF WORK.=; $' e �r r e itch A, re 00 ®ur'i L'o�� - � oio CC1,N5TRlJCTION INF©R ATIO Additiona I work to be performed un er t is permit -Check a tat, apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: 1 Sq. Ft. of First Floor: •ost - Construction: S '71rO0. Utilities: Sewer Septic Building Height: Pl_i^nni-rn.w.r�=rn�. ` X_a me ► Y LOLY1 (om[ C:_ Name: Address: 3. h / r( 1q,5.5,kz--7Yl ca� Company: City: d !'ice P t!!- State:, Address: Zip Code: �1��_ Fax: City: State: Phone No.gv �'/ Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. i �SUPF��E IENTAL.C�tdIUSTRl3CT C (V UEl' "LAW, 3R IATIU •b } a a `� � t DESIGNER ,ENGIN ER: _ Not Applic ble MORTGAGE COMPANY: Not Applicable Name: G �p ncri 1 Name: Address` 03 tD Address: City: Ap I State: City: State: Zip: Sjq. ,* Phone �R Zip: Phone: I FEE SIMPLE•TITLE'HOLDER: Not Applicable BONDING COMPANY: Applicable _ Narrie: " " ` ' ' _Not Name: Address: I Address: City: I City: Zip: Phone: Zip: Phone: I I OWNER/ CONTRACTOR AFFIDVIT: /application I certify that no work or installation has comm is hereby made to obtain a permit to do the work and installation as indicated. enced prior to the issuance of a permit. St. Lucie County makes no representationat which is in conflict with any applicable Ho structure. Please consult with your Home Owners is granting a permit will authorize the permit holder to build the subject structure Owners Association rules, bylaws or and covenants that may restrict or prohibit such Association and review your deed for any restrictions which may apply. In consideration of the granting of this requlested 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 accessory structures, swimming pools, fenc WARNING TO OWNER: Your failure to exempt from undergoing a full concurrency review: room additions, s, walls, signs, screen rooms and accessory uses to another non-residential use Record a Notice of Commencement may result in your paying twice for improvements to your property. A Niotice before the first inspection. If you intend commencing work or recording your of Commencement must be recorded and posted on the jobsite to obtain financing, consult with lender or an attorney before Notice of Commencement. Az��i 1 gpeof O heri`/JLessee/Contractor as Agent Signature of Contractor/License HolderSTATE OF FLORID - , . COUNTY OF 11A:;1 STATE OF FLORIDA COUNTY OFThe I by for oing instr t was acknowledge�befo this day of 20 IV The forgoing instrument was acknowledged before me this day of 20by Name of person making statement. � �N Name of person making statement. a Personally K OR Produced Identifica Type of Identificat' /n\ Produced l/" r �• p l� Personally Known OR Produced Identification Type of Identification Produced (Signature of Nota ublic- State of Florida) (Signature of Notary Public- State of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW i DATE RECEIVED DATE COMPLETED Rev. 812117