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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I O Date: Permit Number. c/ SCANNED Bly 0 Bui33lua.10d I' Inno9 oi�N� -.LS Building �e° AI � lication WE�y W Planning and Development Services Building and Code Regulation Division 43A 2300 Virginia Avenue, Fort Pierce FL 34982 ��� Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PR®P3®SDIVI ,.. f PR®1%EME_NT LO A�TgI®N ,L4 ...re x-W,s '7,�'+. Address: 133 ?"IiaMe-n+ CA Nu+c-Mown ZSlCtnQL M57(49 Legal Description: 49t e AC, Cove- - U.n it 1 6LIA_ 1"1 - LOT E (ot. y0a.9- 9t1q) PropertyTaxlD#: ILI��'I'�bl�011oo�i" C>oo-q Lot No. Site Plan Name: Block No. ProjectName: �kenC e.1 Setbacks Front Back: Right Side: Left Side: ®ETAI' E© ®E�GRIPi"IO,N ®F V1/OR� �$ }{ i F ft, �w� Win. �� ���..,...., soLAe Poo L_ z4•u huw�`+rk.L+M,i.a�4.. �.<inc�a. ��x �,� '�'$�,�....c�7:`�.,tS+;Y °j."�. C'# ry:. ,5 "h M^ b Js _ . itiona wor to e e orme un er t is permit - c eCk a apply: �HVAC Gas Tank Gas Piping _ Shutters Q Windows/Doors Electric Plumbing Sprinklers F� Generator F]Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: OSeptic Cost of Construction: $ 5, 799. 5m Utilities: _ Sewer Building Height: r Name: V-10)�-C Z,«\\ac"YK Company: 5kCLr �e -qq S�Askems Address: \100 Sr l�woo�i e- Name Dial nh VAe-elf-u Address: gar\iarnrtn-j' City: i�t�acLhir�Sor� SS�A� State: FL. City: _J�n rA- i e. i(c-o- State: Zip Code: .?J' LCM 9 Fax: Zip Phone No. VOq- Qa(O- LOV90 Zip Code: ?A44� Fax: T72- q&&-W3% E-Mail: Phone No. "["101- 4-Lg6- cL(alo'3 Fill in fee simple Title Holder on next page ( if different E-Mail: g�V_ Lga_W%ao -Corn State or County License: G!e-- brvio(o3� from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUR LEMENTAL CONSTRU TI®N LIEN LAW INFORMATION: ,..., ""' % :...., DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: Name: Not Applicable Address: Address: City: City: Zip: Phone: Zip: Phone: 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 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 Recordia 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 your Notice of Commencement. 24J K Signature of Owner/ L Contractor as Agent for Owner Signature of Contract6qkkense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S+ 1'Lc:,e_ COUNTY OF VucAe__ The forgoing instrument was acknowledged before me this ]Cft''day of M exe- C%e, 12012, by' The forgoing instrument was acknowledged before me this_&edayof C14r•c%r. 20JS by bec i zra 11 a c K Igo1ou k Zrr-J k 0_CI;e_ Name of person making statement Personally Known �v-' OR Produced Identification Name of person making statement Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produced Made Sarah Musl NOTARY PUBLI Commission No. ff `712131STATE OF FLO (Si nature of Notary Public- State of 4$10 (Signs ure of Notary Public- State of F ) Made Sarah Music NOTARY PUBLIC I�mmission No. F q IZI 37 S STATE OF FLORP.. Comm# FF91213 Expires 8124/2 0 Comm# FF91213-r 19 I Expires 8/24/201 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED tev. 8/2/17