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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLE•i to FOR Date: 5 1 a`3 1 \A Planning and Development Services Building and Code Regulation Division 2360 Virginia Avenue, Fort Pierce.FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: t& / // Legal Description: —41 Property Tax ID #:� 1 "lam Site Plan Name: Project Name: Q� / Setbacks Front Back: `7O "ATION TO BE ACCEPTED L, Permit Number:.-dro 43 RECEIVED BY MAY 2 3 2098 MfMrit Application ST. Lucie County, Permitting mmercial Residential RiRhtlSide: Side: Lot No. ems/ Block No. 7 G% Additional work to be pertormed under tnis permit cnecK all tnat 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: Cost of Construction: $ 2 / .S a- c� Utilities: —Sewer . _Septic Building Height: OWNER/LE=�S�SEE: CONTRACTOR: Name Name: _ CroLAQ.4-�- Address: /61 /y, Company: Z TC_ LL C City:© S� �cv� State: �L F Address: Sl0 �rr���--�, �v �G�� �cL Zip Code: Fax: Phone No. <%%�- 2/6 —/ q (a .,•—$7 E-Mail: 37 Ceo,,( © c­0 ( Cc,I Fill in fee simple Title Holder on next page ( if different from the Owner listed above) -g2 City: - Pod y State:Lr—L Zip Code: J'fi 97 Fax: Phone No 27Z— 26 '— //'Y6, . E-Mail 5%C . (:.1 CAC ZC . R/ l (OC-01 State or County License If value of construction is 2500 or more, a RECORDED Notice.of Commencement is required. !�P'LEM � iAL CQNS7(� Ci"IC*} LIEN LAW IN�F(J MATI®N: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Address: = '"Afd" id-ts: City: State: Zip: Phone ti`13n;;Zi 'City: State: p ! iir:' Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: 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 restriction's 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,wodmr,rRcording your Notice of Commencement. t 6, �/,_ Signatu of caner/ Lessee/Contractor as Agent for Owner Contractor/License Holder =FLORIDA STATE OF FLORIDA COUNTYOF , Sk.. COUNTYOF The forgoing instrument was acknowledge before me �"� The forgoing instrument was acknowledge before me this day of 20 by thislS day of 11"Itiq V 20 Vk by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pu lic- State of Florida )I (Signature of Nota Public- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Iden_tiication Type of Identification IE Type of Identf atici.�DEAN- NA MA—RIE+�G;0220 Produced L. xD Produced 23 EN" NANARIE � 720 . , Commission N r �„ Ull,lsslON � j2023 � � ��,e " '�`' �xpIRES: December 16, 202i1 Commission , oy, ►4i,T ruNotatyPublicl�i l I e �= EXPIRES: December led Thn tlolary public Dnuen>;i . eebva a� REVIEWS l—' yR'C3AT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.