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HomeMy WebLinkAboutappAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEP i cu Permit Number: I Date 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 Residential PERMIT TYPE: �-�O1 �A P wA SCre-e4l1 (Z.pt>rti Address: _;z 110 Property Tax ID#: )y31- IZ)?-- 0OIZ-p00-9 Site Plan Name: Project Name: 3`l 9 Additional work to be performed under this permit- check all that apply: Lot No. Block No. _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: �9 4? Sq. Ft. of First Floor: Cost of Construction: $ �5J CJ Utilities: —Sewer _Septic Building Height: Name ­5'Ahn s42go (1s Address: 2110 Keen Road City: F�- �r,GRUt State: Ft Zip Code: b1tq`l10 Fax: Phone No. --I -1Z- Z© 9 - 91 3-7 E-Mail: Fill in fee simple Title Holder oq next page ( if different from the Owner listed above) Name: CityT­'t -:�' 1 e t Ca State: FL- ZipCode: 3­ICISI Fax:i72- L[(DI-MLI Phone No 172- 21 to - I'�3 E-Mail 1(7'1Ct'1S�'1 L3�c{ @ a mail C.�N1 State or County License O l7lo 3 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. T ON LIE MATZO DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Floi c�a E Weer lLC Name: Address: Y451n -TaXia Y6 rat 5u,te pl`) Address: city:& to State: Ff City: State: Zip:33?8U Phone Zip: 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 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/Contractor Agen for Ow er S' ature of Contractor/Lice se Hol er STATE OF FLORIDA COUNTY OF STATE OF FLORIDA COUNTY OF The forgoing instrument was acknowledged before me Th��;;((o��going instrument was acknowledged before me this day 20_ by thisl�A dda1y- o_f /,1 .� , 2011 by qof�� }�. Name of person making statement. IJ Name of person making stite66nt. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced C ��� ^ (Signature of Notary Public- State of orida) (Signature of Notary Public- S to of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED I' DATE COMPLETED ev. 9/26/1