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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COIV(PLETED FOR APPLICATION TO BE ACCEPTEDja� Date: �� Permit Number: u" S (� 9Z4 BY C%t Q 89PVP pet,11' Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR: Address: / J Legal 42LA Residential Property Tax ID #: ©r ! T IN 2 6 Y Lot No.� Site Plan Name: Block No. 86 Project Name: P(1L,i ( Setbacks Front Back: Right Side: Left Side: RtTY'(0t.:;,�i'1,.1= `f5.F51�v� c�or�i� S f S� Zt1�t` Haaitionai worts to De pertormea unaer this permit— cnecK ail tnat apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator Roof 9�Pitch Total Sq. Ft of Construction: ,� Sq. Ft. of First Floor: Cost of Construction: $ 49) l/v�'� Utilities: _ Sewer5eptic Building Height: ,,. Name Name: Address:%� ��_ Company: ^^ City: _ State: X Address: -;—> Zip Code: 31:11f A ( Fax: City: Phone No. 'i5<A's Ce2 C (I Zip Code: E-Mail: Phone No % Fill in fee simple Title Holder on next page ( if different E-Mail G\ from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. '* I tPPLEMI=NTAL �aN5TRU�i�C? �1N I�ORMAT1U d> DESIGNER/ENGINEER: _ Not Applicable MORTG 'GE Not Applicable Name: Nam Address:.rt`�` Address• City: ,' State: City: State: Zip: 9 ..PFione Zip: Phone: FEE SIMPLE TITLEHOLDER: Applicable BONDING COMPANY: Not Applicable _Not Name: �''':r;. 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 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 commen4g4ork or recordiniz vour Notice of Commenceme t. Si nat of Owner/ Lessee/Contra or as Agent for Owner Sig ture of Contractor/License H4 er STATE OF FLO DA , J ',LtGn�-- STATE OF FLORIDA COUNTY OF o �'C COUNTY OF QV�2(A'ei The forgoing instrument was acknowledged before me `�i�61G 2!7by The forgoing instrument was acknowledged Pefore me day 20�g by this 17� day of 20 of � AdV--- . this /1 /01 A A (Nam of erson ackn wledging) JIM0111e f lAerson ackno ledging ) ure of Notary Public- State ).k,.: IL (Signature of Notary Public -,State -of Florida ) Personail �`,�Pd IId�entification ig �If v�l► te. Personally Knq ¢/�6'�-, d k*8*(Md(l Wtion T e'of ldentifi t' =Comm bSIOn Type of, bommission # GG175422 yp , fe c # GG175422 Produced = • Produced . j. 2022 ~"' '�` Commissi(�i, ,```��� Bonded thru AaronlN %e'al)' • "' Bonded tutu Aaron Commission No'��� REVIEWS FRONT ZONING SUPERVISOR P VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW RE4/ REVIEW REVIEW REVIEW DATE RECEIVED DATE 06 COMPLETED ev.