Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR Al Date: .0A 'SCANNED T � H BY Building PLICATION TO BE ACCEPTED I ''nn Permit Number: ` ®Q,' Oy's rmit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR: Roof I Address: 1 y u ?ez r I i a m QN, Legal Description: T _koS un Property Tax ID#: 1q/q-'7O/- ©/(��- C) Site Plan Name: f C& ' I Project Name: _ A t!:�CY1 Setbacks Front Back: Right Side ,era o J tL. P_*- i -, , q 4n 4t V�L f O O -� se.e,,,,,, Al um; uJ-tA . o 08,4 , Left Side: Residential Lot No. Block No.� Haamonai worK to De errormea unaer tnis permit- cneck all apply: 11HVAC L _ Gas Tank Gas Piping _ Shutters L]Windows/Doors Electric ❑ Plumbing Sprinklers Generator W Roof Roof pitch Total Sq. Ft of Construction: Yq S . FtFt. of First Floor: !J M Cost of Construction: $ -=/a� e)0 , U O Utilities: Sewer Septic Building Height: I �- b1lNERjLE�SSEp CtIUTRACTi3R r 7��0 kz Name L— N ime: �"�`�v�'��_1.�.; Co pany: 0O�r `�GC-of -s ]�_C Address:-�1� u o�<� 1 o.�rl e n�- City: �-y- :t ,t Stater - Adtl-re�ss: a�5lj ��S�- Cit 'I: rr�S' -)- sa— . 1—�-K (,-1-�L- Stater. Zip Code:'?+4 °i Li 01 Fax: rJ Phone No. +1'"1 a --11 3' 3b(0 Zip Code: 1----Jt4 c)5A Fax: t,1 � E-Mail: -9—vlk.S �k 1k, Pho�eNo. "ll-11�.- E-Mil: Fill in fee simple Title Holder on next page ( if di ferent State or County License: from the Owner listed above) It value of construction is.52500 or more, a RECORDED Notice of Commencement is required. ; moil DESIGNER/ENGINEER: Name: Not Applic 'ble MORTGAGE COMPANY: Name: Address: Not Applicable Address: City: Zip: Phone State: I I City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: Address: City: Not Applicalble I I BONDING COMPANY: Name: X-Not Applicable Address: City: Zip: Phone: I I Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is h�reby 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 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 Associa ion 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 froI unredergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, sign s,lscen 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 mencement must be recorded and posted on the jobsite improvements to your property. A Notice of Com before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or eco rIg your Notice of Commencement. I Signattre of Owner/ Lessee/Contractor as Agent for Owner Signat re of Contractor License Holder STATE OF FLORI STATE OF FLORID�/ COUNTY OF_ �� ,-Ur,/.�, COUNTY OF J y. f e !�, The forgoing instrument was acknowledged before me The for oing instrumt was acknowledged before me this c3G day of �2i_ 20/� by this day of 20 /A by Name of person making statement Name of person making statement Personally Known )% OR Produced Identification Personally Known -A OR Produced Identification Type of Identification Type of Identification Produced Produced (Signatu a of Notary Public- State �f Flori (Signatur of Notary Public- State of Florid CommissIS-01 OP al) r Commission 1444 � r ru MARK KENNY Commis �i t Commission#GG14449 (Seal) ,. � es p m r 19, 20 Expires September19,2021 ''FOF�o��v ladodThu suag.cNomrrsorno» OF F� REVIEWS FRONT ZONING SUPERVISpR PLANS EGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW I REVIE REVIEW. REVIEW REVIEW DATE RECEIVED DATE �lo COMPLETED! tev.8/2/17 I