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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COIVMPLt7ED FOR APPLICATION TO BE ACCEPTED Date: ��— .� L Permit Number: SCANNED Building. Permit Application RECEIVED Planning and Development Services APR 19 1010 Building and Code Regulation Division I Permitting Department 2300 Virginia Avenue, Fort Pierce FL 34982 I 5 . Lucie County Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: PyROPOSED INPROVEMENTLO.CATION!. Address: _ 3 D G 6 SEti 7' f 4,W,67- p l 1 fiP Fo aT Jul er2G:e �-��. 3i �/•S l Legal Description: Property Tax ID #: I��� -1 • 00 I• ©0�?� Lot No. Site Plan Name: I Block No. Project Name: Setbacks Front Back: I Right Side: Left Side: I ;,DETAILED DESCRIPTION OF WORK,aF F L2&Q — /0' r2om MQr;tP IgAin P PPS* Z boy e CONSTRUCTION INFORMATION Additional to be pertormed under this permit— check k a11 tat app y: _Mechanical � s Tank Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ `a-0 Utilities: —Sewer _Septic . Building Height: bWN ER/LESSEE.: ' r CONTRACTOR::. Name 6--HO &Ql" Name: E/ZIC, `W ACNAPG Address:Sq0 �V a c..> y�'l�i2crt ! (� %�'/ P Company: S ec.c)&4. AS'_ C.• City: State: L Address: l 3l 60 7'�� Zip Code: 3Y (o Fax: City: &J 7A.V State: X1 Phone No. Zip Code: Fax: 328 Phone.No S32 57666 6/00 E-Mail: Fill in fee simple Title Holder on next page ( if different E-Mail C &-e A — from the Owner listed above) State or County License -? If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. r •� I �3 SU,PPIEMENTAL CONSTRUCTION I.fEN tAW IN ORMATI�.N ,. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: _;Name: Address: I Address: City: State: City: State: Zip: Phone I Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address:- I Address: City: I City: Zip: Phone: I Zip:. Phone: I OWNER/ CONTRACTOR AFFIDVIT: Applicatiok 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 gran, ting a permit will authorize the permit holder to build the subject structure is in which 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 perYnit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida B l ilding 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 Recordla 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 our No ' e df Commencement. Qm'I ature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF :�it/`.O 119IV ' ' � t V STATE OF FLORIDA COUNTY OF The forgoing instrument before The forgoing instrument before was acknowledged ml was acknowledged me this dav of 204gby this day of 20_ by (Name s , acknowle ing) (Name of person acknowledging) (Signature of 6ofary Public- State o ida) (Signature of Notary Public- State of Florida ) Personal, Known OR P y Produced Identification�,� Personal, Known OR Produced y Identification Type of Identification Type of Identification Produced_ MZ 10 712 70 21 1 O I Produced Commission No. ��FF V'd;;e.;(Seal) SHERRY TbOMEY mission No. (Seal) ; � t Notary, Public - State of Flori_ • : : �'_ My Comm. ExpireslM*y 19, 2 Ta REVIEWS %, FRONT "„7nKOFF�O,�� o onded miss on ssn ' NS VEGETATION SEA TURTLE MANGROVE E IE R ^ I I COUNTE REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED I Rev. 7/2014 DESIGNER/ENGINEER: Not Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip:. Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 1 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 Horne 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 ur accessoryStructures, swimming pools, fences, walls, signs, scr WARNING TO OWNER: Your failure to Record a Notic improvements to your property. A Notice of Commi before the first inspection. If you intend to obtain fi commencing. work or recording Your NoVe of Com of ergoing a full concurrency review: room additions, n rooms and accessory uses to another non-residential use of Commencement may result in your paying twice for icement must be recorded and posted on the jobsite incing, consult with lender or an 510 t rney before encement. .1• as Agent for Owner. ' I Signature STATE OF FLORIDA COUNTYOF :G/t/`��91v Q.t VL°2 se Holder STATE OF FLORIDA COUNTYOF 2A',Pvyv kiLi-e7 The forgoing instrument was acknowledged before me this y of Aql2rt .20 y The forgoing instrument was acknowledged before me this i/ day of A P2r z 20_1�g by (Na cknowie�lging) (Name ofson knowl�gigg ) `(Signature oflWary Public -State oU-JaIrida) t�rgnan Personally Known OR Produced Identification Persona Type of Identification Type of Produced M-:;, 3 Q Z 1.2 70 -Zi l 0 Produce Commission No. d',� (Seal) SHERRY YOOMEI �fi 5 Notary Public - Slate of, • . My Comm. Expires May 1 REVIEWS I FRONT COU NTE MPLETED Public- State of Florida-)— LZOR Produced Identification iv l­!)Rqunu! BlOZ'6l Ap N saildx3 wcua� A3WOor Aa46. l3HS ' R VEGETATION I SEA TURTLE MANGROVE REVIEW I REVIEW REVIEW Z'd d6I,:90'SI, I•I•add