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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAII.APPLICABLE INFO MUST BE COIMrL:cTED FOR APPLICATION TO BE`ACCEPTEU - Permit Number: Q Date: SCANNED Z 7101g pen,,Mgg Bilding Permit Application StItti ung pa�� Planning and Development Services cuntY e nr Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 lCommercial Residential _l/ PERMIT APPLICATION FOR: PRfJ►PfJSEa INPRO\IEMIENT` L CAl'ION: /�dd�r+°es f3DOx� �Q�i'� e ��c� • F�r� /�i�✓'ce- Legal Description: roccn O©c) Lot No. Site Plan Name: Block No. Project Name: ,efibadk' Fidit,�Y.�y. 3'Bek ` ��g{#5Cde .lr'�L;,;Sild 99is[tDrtSY�M. u f !d DETAILED D080RI2TWN O W®RK: /oi-i cl c CeIr n l) r� �. - CQNST +UC ION INFOR' TItJN• Additional work to be pertormeci under this permit— check all that apply: _Mechanical _ Gas Tank I Gas Piping _ Shutters -_.L/Windows/Doors' Electric Plumbing _ Sprinklers _ Generator Roof Pitch d - VTT.rt cti n: � Sq. Ft. of First Floor: C6st.6K23WAM?' tion. $ = ' , 000 I Utilities: —Sewer —Septic Building Height: ®WN'ERf I.E=�SSEE (dNTRACTOR: arrCe 2re..ncict- s Josewheraer -Name: Address: good 4.fOm�;z /�CP. I� Company: State: �L Address: City: ��rf P�e�, City: State: Zip Code: ,94C%Fax: Phone No. 712 ­ qq U — IS25 Zip Code: Fax:' :.: :, Phone No 1.MMai "_ ,.:.r ter`=Triitle Fill in fee simHolder on next page ( if different E-Mail State or County License from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. Sll� PI.EM�ENTAL GONSTR� I'ON LIB LA I � R111lAT ON: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name:. ' Name:. ...:.. Address: I Address: City: State: City: State: Zip:. Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _.Not Applicable BONDING COMPANY: Not Applicable Name: I Name: Address: I Address: City: City: Zip: Phone: I I 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 Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice ofliCommencement 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 our Notice of Commencement. Signature of Owner/ Lessee/Contr ctor as Agent fort Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S L.a e : e i COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of Vv.*_k 20 1A by this day of . 20_ by I (Name of person acknowledging) (Name of person acknowledging) I � I i (Signature of Notary Pu lic--State of Florida) (Signature of Notary Public- State of Florida ) Personal) Kn n,.r°���,eU3,•.. Ca y "°' ORU;4W8W$I ti °� Personally Known OR Produced Identification Type of Identi i�ia'o �, MY COMMISSION # GG 022023 = EXPIRES: December16,2020 Type of Identification Produced Produced .,'� bllcUndenvriters Lei;;; .Commission No.� (Seal) ' I Commission No. (Seal) REVIEWS FRONT ZONING i i SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED�ib DATE COMPLETED ev. I