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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPL ZABLE INFO MUST BE COMPLETE FOR APPLICATION TO BE.ACCEPTED Date: oil � rJ Permitt Number: 35 Ot-d`1a5 RECEIVED AUG 2 7 2015 BY1E)cognty I1nd Building Permit Application 8t.1Lur, Planning Development Services Building a l d Code Regulation Division 2300 VirglllI Phone: (7172) is Avenue, Fort Pierce FL 34982 462-1553 Fax: (772) 462-1578 Commercial Residential_ PERMIT d APPLICATION FOR: To Select from dropbox, click arrow at the end of line R D IMPROVE(UIENT LOCATION' s {�a' Y APROPOS .. �.a: � __ �_ .:._ Address: 7 4 7L) r4 P1 25 qC7 Legal Description: ��� / &&?7d <6 Property T (ID #: 1Y/ 66 rr% `000 "7 Lot No. _ 'me: Site Plan N Block No. Project Na e: rontb Back: S' Right Side: 3 Left Side: �f Setbacks CONSTRUCTION s INFORMATION # ' �.x Additionalor to be nertormed under this permit — check all apply: FHVAC L_I Gas Tank I Gas Piping_ Shutters Windows/Doors 11 Electri ❑_ Plumbing Sprinklers I Generator D Roof Total Sq. Ft ConstructiorVz S . Ft. of First Floor: �'5 � 7 Cost of Cons uction:_� �% /,S� Utilities: Sewer E]Septic Building Height Name Name: Company: ` Address: Stat Address://�r'oD4na(Y City: Zip Code: ©?(io Fax: —' City: aip.� State: Phone No. Zip Code: Fax: y E-Mail: Phone No. 1� �a✓ le Title Holder on next page ( if different E-Mail: "10 D Fill in fee sim' from the Ow Viler listed above) State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. II SUPPL CMENTAL CONSTRUCTION LIEN,LAWINFORMATION `x S v DESIGN R/ENGINEE _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address Il Address: State: City: State: City: Zip: II Phone: Zip: Phone: FEE SIM LE TITLE HOLDE Not Applicable BONDING COMPANY: _Not Applicable e: Nami Name: Address: Address:' I City: City: Phone: I Zip: Phone: Zip: I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Co' myy makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in 'onflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. ease consult with your Home Owners Association and review your deed for any restrictions which may apply. In consi( itlon of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordanlIce with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The followinig building permit applications are exempt from undergoing a full concurrency review: room additions, accessory s �uctures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNIN TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for improve dents to your property. A Notice of Commencement must be recorded and posted on the jobsite before th 'I first inspection. If you intend to obtain financing, consult with lender or an attorney before commenc:ng work or recording our Notice of Commencement. Signature STATE OF i s f Owner/ Lessee/Agent LORID IF nature of Contractor/License Holder STATE OF FLORIDA COUNTY T k.forg oin i da inst ent was acknowledge'tfefore me of 20 -by COUNTY OF The for oing ins u ent was acknowledged before me this ay of , 20 by ( me of person I (Name of person acknowl dging ) acknowledging i (Signature o IN ry Public- State Florida) (Signature of tart' Public- Stat of Florida ) Personally Kn wn OR Produced Identification Personally Known OR Produced Identification Produce o. „ I ••„ MY COMMISSfON # FF 014070 �:,� (Seg1(PIRES: July 27, 2017 ,qf� q. BondedThruNotaryPubllcUnderwriters Type of Identification Commission ype of Identification Pro , Y P�= DANCES D0 ZA +� MYX��N # FF 014070 ommission No, a° °�= E S: ul 2 ••••oe.'� y 7,2017 .9 5R Bonded Thru Notary public Underwriters Revised 07'l15/2014 I REVIEWS i FRONT COUNTER ZONING REVIEW SUPERVISOR REV EW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE COMPLETEJi 1 I� INITIALS I li