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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFFOi MUSCT2 BE COMI ''iD FOR'APPLICATION TO BE ACCEPTED Date: 2 I IU Permit Number:—UToLL� ® RECEIVED RYJ o `f.; 1 T'- ,1 DEC 2 U 2010 Burriding �� Permit A NCatjoWst,mlttlny Department Planning and Development Services Lucle county SCANNED Building and Code Regulation Division BY 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential_ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Lot No. _r Block No. �I DETAILED DESCRIPTION OF WORK: RefZ rc"o ex l s ng ro S_temGoU_5n ro �y'A W SUb S+yaAe (�2rm�1 Phi,mCtCY,m- 8D rtno\sYuLnK..n�,-!upp►H-vinsbII f�.111� tact ��CI i.�1C�S1-nO�Yv`Q�,� . 1ns-iet� r�ew sv rv>.�(Z row �s4em us�n � I��zacscreltis. CONSTRUCTION INFORMATION: ❑HVAC D Gas Tank DGa< Electric 0 Plumbing E]Spr Total Sq. Ft of Construction: (12 19 Cost of Construction: $ 53M Shutters VdinC Generator L." Roof Sq. of First Floor: _ Utilities: L _JSewer Septic Building Height: S ^OWNER/LESSEE: CONTRACTOR: Name 1.1\)#k 1 F op Name: AddrQfr tom_ ess. Company: 1 Re -pox V /� City: ^ I 1 State: MA Zip Code: ©ZOOi-S Fax: Phone No. ___TTZ 332 - S Address: 0 V R1.1CC(iC nCff) Dn V?_,J City: itIra State:_ Zip Code: �i41zna?— Fax: Phone No. E-Mail: N if CC) 10 1 Opo I I - 01 Fill in fee simple Title Holder on nex page ( if different from the Owner listed above) E-Mail: 1 State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTALCONSTRUCTI"IEN LAW INFORMATION: Name: Address: City: State: Zip: Phone MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: 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, arressarysrructave� swAwn ing pants, fences, xQ4 5Rn-% srreen roDaxs and arressuy uses to anwfkefncw-res denYial 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 commencine work or recordine vour Notice of Commencement. Signature of Owner[ Lessee(Contractor as Agent for Owner Signature of Contractor(License Holder STATE OF FLORID STATE OF FLORIDkt . p COUNTY OF II lrlt, COUNTY OF IBC 1� The f ing inst ent was cknowledge fore me this day of Pam. 20�I by The for ing inent was ck gwlecig rJ I�efore me thisday1ofY 20�iS by a4u P I h Q Name of person aking statement Name of perso aking statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced —6qj��Aa— — Produced 'a &ZN0 a ur a Pu lic- i na otary Pu tic- State of Florid 0 KATHERINE HAVENS ' fuPlf }ISSION#GG165030 Commission No. o, KATHERINE HAVENS Commission No. MY�ete'I$SION#GG165030 Fri EXPIRES: DEC 04. 2021 �.1m IXPIRES: DEC 04, 2021 Bonded through 1st State Insurance Bonded through 1st Stale Insurance REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE R01 COMPLETED Rev.8/2/17