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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COM Date: 3 3 FOR APPLICATION TO BE ACCEPTED IPermit Number - Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772)i462-1578 Commercial =EED Residential PERMIT.APPLICATION FOR:I To Select from dropbox, click arrow at the end of line a�� PROPOSEDIMPROVEMENT LOCAgTIQN }� _'TM�,� y Address: `j R U1LZ):) q-rV L_ - - �j r``n,�s C�'� Z eA-C H q ' S- Legal Description: S A ►� (t L� T i� x 12(i l,c. U)4 uE A- L- I Property Tax ID #: L(i_QLi�I3 i -I - CAD Lot No. Site Plan Name: SI{(� m�A-cy L,42N'c Block No. Project Name: A-Q QJJLZ (\J 5 Setbacks Front JBack: Right Side: Left Side: I'DET'�AILE6"DESCRI!PTIO'N',".QF,WORK, .1 a+N GC ���CoN1fL}t'fU�. 1 A' e-rAL, vZ—CA�r ` (ZCY(_ACt%1J_r' A ,3tj0 W-LTfi Ze4C POUF ��c1tlNSsoc�; �ro.0 C>U�1�YL ��4 SC ��'�� Po�C ki. ICE t,J �2e N i �'o2C N. /aOD�'izorvAL A-910 vN�o it �� ��rs�ry G (zo o c NO k 3 0 'GONSTRUETION `INFOFtIVIATION u Add itiona I work to bortormed under this permit — check all apply: 11HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors Electric is Plumbing Sprinklers Generator 00 Roof Roof pitch Total Sq. Ft of Construction:rr�� L4t S 9 i S . Ft. of First Floor: `I Cost of Construction: $ 60, C�0 UtilitiestSewer Septic Building Height: t2 f T 011VNER/LESSEEe ..W CONTRACTOR: Name Name... 5f -� ?-z Address: 1(4)3� 95 'MPr-v% LA-Nt Company: City: 30­-�Scro BC -A! CH State: FL_ Zip Code: 2)4 1 -5--1 Fax: 1-77-' 3 6 © - i 01 Y Phone No. Ji+z_ Address: City: State: Zip Code: Fax: Phone No. E-Mail: E-Mail: 1 Cam`- 0, (A CATS o s` C, C- 0 M Fill in fee simple Title' Holder on next page ( if different from the owner liste'd above) State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. ? Pf..3las SUP,P2yO.FMENTAL � •: 3'3 "*�" "64s'T UCTLOS N LIEN3,LAW INFORIVIATIgOgN. .{1 �`-.'f1': .l. ikS,J 3`a.Kad 4d4 rt� � JAi hsk: Ym _ DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: JckotMA I?p1vv i Address: Ill 05' r-_-tDCoE AMC- Address: 1\9l-1 &V_ U kW Y 1>4_t 5tu7' 80 City: AtJW A-L43o2 State: Mr City: r-o2i State: F C- Zip: 3`t i Z- Phone 3-- 0 - c1 `i ko i Zip: `1 R l CD Phone: c- g B S - (r, k (o -G 96 (o FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: 5lg-4-E1 M�L&Q'fL 4 y')I6c 4056-L k - Name: Address: 10-4 54-t`Q.4.`0AnN L/r-NE Address: City: J F`+J Sri -3w-e.k+ I City: Zip: Phone: Zip: ?,y q 5 Phone: �� Z- SZ`d- b S� S 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 thatlls 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, vjalls, 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 cnmmencing wnrk nr recording vnur Nair-p of Cnmmencement_ 1111111111101 I Signature of Owner/ Lessee/Contractor as Age6t for Owner Signature of Contracto icense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF U16 COUNTY OF a W c e The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 622. day of MQ 1(L� 20 by this 2day of K/Ia Mh 20ffby � -Pry �1 � I l ~✓r I Je � M � I I e( Name of ersorymaking statement I Name of p rson making statement Personally Known ✓✓ OR Produced Identifi ation Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of NotaryPublic- State of Florida) I (Signature of Notary P blic- State of Florida ) Commission No.G6 IL) 9, ' ' P ,.,: (Sel 'M,CAILLIER Florida � DO(�@t1I,AILLEI R Commission No. l7RgEA : Notary publicl- State of :: NotaryPublic- toteofFlarldaCommissior II GG 148944 man, My Comm. Expires Feb 1, 2022 • Commiss(on II f,G 148944ys �; My Comm. Expires Feb 1, 2022 „ one r Bonded through Iona o uny s . REVIEWS FRONT PLANS VEGETATI MANGROVE N G SUPERVISOR TURTLE- COUNTER IEW kEVIEW REV REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ? tev. 8/2/17