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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONIALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Permit Number: Date: 1' �i� SCANNE�JPer .. f udeCounV RECEIVED j -- Building Permit Application Planning and Development Services JUL 2 0 201$ Building and Code Regulation Division ST. Lucie Ee ty, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ` PERMIT APPLICATION FOR: , P4L4-ta&iq. o;i PROPOSED IMPROVEMENT LOCATION: Address: Q7n o •Pja.i12 C'3` D0n4- iL V C t P 9 99 Legal Description: -1P4IQWp14 L t n LG J- QT.2-5' ^ ?4 2 Property Tax ID #: S TZ'Z ' SOo 13 -- O ©O - % Lot No. Site Plan Name: Block No. Project Name: 0-A9-yCV 5 Ls�en 4?nf Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: ��w►��c� tk4os�PA "11, -rc",Qik Sep Q V rACW pvanT +- specs CONSTRUCTION INFORMATION: Additional work to Morme un ert ispermit-c ec a appy: Gas Tank ❑Gas Piping _Shutters -N�Iectrric Windows/Doors 0-P-1 umbingSprinklers E Generator 0 Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ r 6 T9 Utilities:Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 1'sernr2lCv r kV Q -Wv%&An4 Name: /-.. n G� , I t Address: 97WO FW�w4X'10 Cd-• 14 Company: 4Lo ►clatt,L1 LL City: 00(4 si'Awnk— CvcAsa State: JE"- Address: J%U SW Nb,�q* 121)-- Srik .1 Zip Code: G Fax: City: S�� State: Phone No. 6 "' S 114 °) C7 Zip Code: 34 99 1 Fax: 7W-2(g? E-Mail: JjArASL V!3 Wm&� nQ e- Lf,-4 • Lo/>, Phone No. -7,72 2- Fill in fee simple Title Holder on next page ( if different E-Mail: Q State or County License: C 6 C 15-1 01 2 from the Owner listed above) Value or construction is $2500 or more, a RECORDED Notice of Commencement is required. UPPLEMENTAL 1Si . CONSTRUCTION LIEN LAW INFORMATION DESIGNER/ENGINEER: X= Not Applicable MORTGAGE COMPANY: Not Applicable ame: Name: _ Address: Address: pity: State: City: State: I, Ip: Phone I Zip: Phone: EE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable ame: Name: ddress: Address: ity: City: Zip: Phone: Lip: Phone: b d.W NER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. III ertify that no work or installation has commenced prior to the issuance of a permit. Stl Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure w ch is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such Picture. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. 1r1 consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work i accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. e 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 ARMING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for 1 provements 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 le�ler or an attorney before C� mmencine work oe recordim--vour Notimof Commencement. of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder ATE OF FLORIDA STATE OF FLORIDA )LINTY OF�kQYhV) I COUNTY OF PA,-�JY) forgoing inst ent was acknowledged before me day of ' I 20_[L by Name of petson making statement tonally Known 'A OR Produced Identification a of Identification (Signature of No. iila MRY PUBLIC STATE OF FLORIDA CGG213453 Expires 5/24/2022 The forgoing instrument was acknowledgeJ before me this �n day of )y� 20 by Gam„ Cv b4 Name of pe son making stat ment Personally Known X OR Produced Identification Type of Identification (Signature of Nt Commission No. ZUNNY RODRIGUEZ 9YATF� OF FLORIDA Corr�j�213453 � Expires 5/24/2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE I MANGROVE I COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW uA I t ',RECEIVED 19 ATE. j ',,COMPLETED i�v. 8/2/17