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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c/ �3 • Date: J ' U ' Permit Number: 7 SCANN .- BY RECEIVE® 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: Address: `"�-Do Legal Description: Property Tax ID #: _ Site Plan Name: _ Project Name: 1 Setbacks Front_ �Q9P.1p(1-MMY> Building Permit Application APR _5 2018 Permitting ,D, eep rtment Commercial t' ie sty, FL ..to0) - I V ^ Lot No._ Block No. Back: LS�-' I Right Side: -L`eft`.Side: _ C �_ Ir Additional work to be pertormea under tnis permit- cnecK ail tnat apply: _Mechanical _ Gas Tank _ Gas Piping; : _ Shutters"- =•Windows/Doors- _ Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: I,Q K 9-0 Sq. Ft. of First. Floor; Cost of Construction: $ �, ("��� I Utilities: —Sewer _Septic Building Height: ©WN ER/LE=�80 CONTRACTOR: Name �Lt CE >K t Name: Address: 0�-b C) CEZC Company: City: 2 State: V(G Zip Code: S(4a,S I Fax: Phone No. `-'S�-( aouk l(DOS E-Mail:+C\e-CNC�Q1.9-_ @ VCLC-160• COS Fill in fee simple Title Holder on next page ( if different from the Owner listed above) I Address: City: State: Zip Code: Fax: Phone No E-Mail State or County. License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEIIJIENTAL CONSTRUCTION LIEN LAW INFORMATIO DESIGNER/ENGINEER: — Not Applicable MORTGAGE COMPANY: Not Applicable .Name: XC:vliNe k.. - u-p NX'N Name: Address:. ar@'`<<` "_ ' .M."` . Address: ".a ; Stater City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: *re; s-s;:7 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 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 commencing work or recording your Notice of Commencement. i natue o O ne Les a/Contractor as Agent for : '"""_ Signature of Contractor/License Holder - STATE OF FLORIDA;,, STATE OF FLORIDA COUNTY OF Ji o COUNTY OF The forgoing instr ent was acknowledged efore z mg The forgoing instrument was acknowledged before me this a day of 20 Eby m this day of 20_ by vwgx (A M/ S) � P3,- (Name of person acknowledging) (Name of person acknowledging) a• (Signature of N t Pu lic- State of Florida (Signature of Notary Public- State of Florida ) Personally 144fo-ON OR Produced Identification Personally Known OR Produced Identification Type of Identificati Type of Identification Produced 16 Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014