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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE 6: ,.*IPLETED FOR APPLICATION TO BE ACCEP i eb Date: Permit Number: 0©s"��� IIIIIIM . 5m _ 13Y ..- _. ' i d a? ermit Application MAr.21 zap Planning and Development Services Permitting Depa St. Lucie County Building and Code Regulation Division tY 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: dc.,f rtj 2 L( )(30 /fdd, h Address: _S 5 U 'Al r- Fl ,Ai -_rye Fl-- 3 42'b2- Legal Description: 1`'i4d#or4 41ver -f5J&iLe_S - 1voi-f 06- hLk 2-2-5 33Pr f} l( �4 1( v� 3 �� t\( 0- 375?-112% Property Tax ID#: 31402, , 607— 62 3S--I;000- Z i Site Plan Name: Proiect Name: /-fvrl-V Uvf hu./JiP-S / PPI hO14 Setbacks Front Jr% G Back: Right Side: Left Side: 2, 7 • �fZ Lot No. Block No. Aj44.7u Tonal work to be pertormed under this permit- check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: ZA0 � fr Cost of Construction: $ L� °Oy Utilities: _ Sewer _ Septic Building Height: / CVI%NER/LESSEE. ;: CONTRACI'QR: Name Tit PVV,1 c:l Name: Address: lD V- Company: City: F�, t% e- r C-9- State: PL Address: . City: State: Zip Code: .� if el'j Z- Fax: Phone No. 217_ L!(IV - IQ SS` Zip Code: Fax: Phone No E-Mail E-Mail: 1.,-ur[z 2 SSP4,L ` d664VI Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or Count License If value of construction is 2500 or more. a RECORDED Notice of Commencement is reauired. b I/ DESIGNER/ENGINEER: _ Not Applica Name: Address: City: State: Zip: �, F,, Phone FEE SIMPUJI TLEMOLDER: Not Applicable Nam`e:.,vw a Address: . City. Zip: Phone: MORTGAGE COMPANY: Not Applicable Name: ai=e�e,cd 14A f_4E__ . op . Su. 3 a City;nlc� Z v►^� Ll State:.nL Zip; C 6 PC0-g"hone: 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. 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 our Notice of Commencement. Signature of Owner/ Lessee/Contrac or as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID ! STATE OF FLORIDA COUNTY OF.�. COUNTY OF The forgoing instrument was acknowledged, before me this day of max',, , 2011 by W%kD The forgoing instrument was acknowledged before me this day of 20_ by (Name of person ackno ledging) (Name of person acknowledging ) (Signs re bf Notary Public -State of Florida) (Signature of Notary Public- State, of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal)- Commission No. (Seal) REVIEWS FRONT ZONING' SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVI REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED I ev. 7/2014