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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLe-] t0 FOR APPLICATION TO BE ACCEPTED - Date: Permit Number: �Do2 ' Ca3 e SCANNED} Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: 1 7 St Rude County RECEIVED Building Permit Application FEB 0 9 2616 Permitting Departmen- St. Lucie Count, Commercial Residential X_ fl D1►� `���.�2 Address: L , )c�RS o , Legal Description: PCa 6 ? Property Tax ID #: 3 a.5 -Zaa—O �,5� tj a0 I Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Haaitionai worK to ae perrormea unaer tnis permit — cnecK aii tnat appiy: _Mechanical _Gas Tank _ Gas`Piping _Shutters XWindows/Doors' _ Electric _ Plumbing Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction:Sq. Ft. of First Floor: Cost of Construction: $ Utilities: —Sewer —Septic Building Height: Dlll/NER,ESSEE�CpTRACTORk.e mo Y. Name C�5 Name. Address:-7 Company: 41jhrtj —S . P.2 aa�e- City: `Z,- States Address' 1 2P Zip Code.'�f Fax: City: ,^,P�P�I CD 2 State:. Phone No. '7'Z2> (33A — YL ;3 7i Zip Code: q� Fax :7Q �,-- E-Mail: Phone No Z— q (D `771 Fill in fee simple Title Holder on next page ( if different E-Mail W4_1 YZS CgCO Q AD/-: from the Owner listed above) State or County License'' �n`�'� If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. StENFA�`I. C+D�ISTF��� IaN �.�EN i.��li II�t�RMdATfE})`I♦ DESIGNER/ENGINEER: — Not Applicable --MORTGAGE COMPANY: — Not Applicable Name: -Name: Address: I Address: City: State: City: , State: Zip: Phone i Zip: Phone: FEE SIMPLE,TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: I Address: City: I City: Zip: Phone: I Zip: Phone: 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 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 is in which 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 ssociation 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 commenr4ng work or recording our Notice of cementl Signature of Ow er/ Lessee/Contractor as Agent for Owner &gnure of Co tractor/License Holder STATE OF FLORIQA_ + LNI G`� COUNTY OF COUNTY OF STATE OF FLORIDA L The forgoing instrumerlt was acknowledggd befl re me The f�going inst%Lmgnt was acknowledge c# before me this A day of 20A b this day of 20_by W ZtL, (Name of person acknowledging) (Name of person acknowledging ) (Signature of Notary P blic- State'of Florida) (Signature of Nota ublic- State of Florida ) Personally Known OR Produced tI Type of Identification ON S Produced Personally Known OR Produced Identification Type of Identification � T Produced �1-' •pOpYpjpy DEANNAINARIEI�I�°FC19 f gpNNAO1 #GGOZ2025 CO ' bes 16� 202� • .. MY t©t, MY comi'AISSION # GG 0220 �'Q` S:DePember96.?nt3 RES:De�m�b�� nJen Commission N ? � t Se FI Commission No. ��5� oc 8 , Notary l'ubllcUr 3er•'''+ heu4.1r sN .o' gone I ,P;:.`••• ....,,..,.--+�;u„�r REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED I ev.