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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO M ST BE COMPLL . .& FOR APPLICATION TO BE,ACCEPTED Date: �� I' Permit Number: Building Permit Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 COfllnlercial PERMIT APPLICATION FOR: P.R.©POSED IN'M L * E1 ENI LOCCATION: RFc,' SC'%, Applicati6Wzpl,o10 f 41J &e F® . Q 00 u tmeryt COV%& Residential k Address: iPo5ma-� Legal Description: (A I(G Lcioob f?,An t At—) L PropertyTax ID #: «Bt (5, D0n7- 0/:)/) O Lot No. Site Plan Name: Q Block No. Project Name: Setbacks Front Back: Right Side: Left Side: � _Mechanical _ Electric _ Gas Tank Plumbing Total Sq. Ft of Construction: 3360 - C-" permit — cnec _ Gas Piping _ Sprinklers Shutters _ Generator Sq. Ft. of First Floor: Cost of Construction: $ I Zap' " Utilities: -Sewer _Septic Windows/Doors �( Roof 3r1 Z 4P Pitch Building Height: OWNER/LT SSEE: CONTRACTOR: Named t;t7iato t s Y--V6 kiVLCrf Name ,ST✓V.E�pscdNFu,�ti.� Address: Company: �6SratiS6tai4+A-aOi=1 JCS l.l�C P.. City: STntG�d?..ZS id+'<7 State: N `f Address:.?2 i ,�-i D Y2 A ow — City % Ptl i&> Cie- State: FL Zip Code: 16 cot Fax: Phone No. 2 0 ( q25-- & (7� Zip Code: 344 9 2 Phone No —n-2— zV%-8'0L�"7 Fax: :)2z 4te1—(o(45— E-Mail: Fill in fee simple Title Holder on next page ( if different E-Mail State or County License 6Z 053-r-73 O from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTrAL CONST' ION LIEN LAW INFORMATION DESIGNER/ENGINEER: Name: At&crf ir0iw7yA1r1-, — Not Applicable zoc-, MORTGAGE COMPANY: _ Not Applicable Name: Address: 5rp& FaL4 ,a2Fi . -r6 Address: . City: -67' P.a2CL.y State: jcjrL Zip: 3,4g5TJ Phone. �7z )i moo 7-)S I City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: _Not Applicable 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, 1 do hereby agree that 1•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 accessoy 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 inspe If you intend to obtain financing, consult with r or an attorney before comment' w r recor ing your Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA OF S�_ LkC1 STATE OF FLORIDA e1� COUNTY OF COUNTY The forgoing instrument was acknowledged before me The forgoing instrume t wacknowledged before me this_SSdayof ) 20Irby this _day of DQ 20-Tby ,'+ie_ven C'as'-U�av a OffV%i"1 P �Q �7�tX �1 Name of person making statement. °� T/ Name of person making statement. i , Personally Known OR Produced Identification " Personally Known OR Produced Identification Type of Identification Produced C �l� Type of IdentifiVOL Produced Ti-L (Signature of " ' Ji -Stt Nil OHN _�'ta e o Florida -Notary Public y Commission p,rG (Signature of o� ' �wJ�lic- t� AUGH �,'e-SComof Florida-NofMblic 7`70079 Commission N '?�c My Commissib?F@kpires a Commission mission p G(Si�7 .�"n,�,t,"`` October 22, 2022 ommission E Ires8 October 22, 2p REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ' Rev.8/2/17