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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETr.'rOR APPLICATION TO BE ACCEPTED Date: I/Z 3 // 5 Permit Number:y NG \— 0 S 5 [J - -- Building Permit Appli 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 LtJAN 2 8 2019 Ggunw, Permitting Residential PERMIT APPLICATION FOR: ANNE® 24. -R E_) �jPl& S- E Pj IN.Pv EKEN T I LOCATION: Address: 17 mA 5&5Tic� (,JAY. RUrgr1i143044 145*-00bl-�!? FI—. 3y9Yg Legal Description: PropertyTaxlD#: ��i 1'� Site Plan Name: Project Name: wj4 cWaJ ?-2PtAC—p%o. r Y Setbacks Front Back: Right Side: Left Side: �-av,0-4W� 15�:XCW?46 rX -Ir--g-e- &,.)i d arpo-5 10.w4r%00w-5 y 000lt5 _Mechanical _ Electric u _ Gas Tank _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ / 2, _ Gas Piping _ Sprinklers Shutters _ Generator Sq. Ft. of First Floor: Lot No. Block No. Windows/Doors ' Roof Pitch Utilities: _Sewer _Septic Building Height: OW N ER/LESSEE: C©NTRACTOR: Name SQtlPAS 'A WY4r1e Name:. ' f`tGZZa;tLoxlz Address: 17 tnATe-S7 +e- wAr Company:' City: F,XQttinaoq ISL444 k . State: --EL. zip Code: R Ci Y 47 Fax: H1,4 Phone No. ys 3 Address: - City: State:_ Zip Code: Fax: Phone No _9Ey-Zly- E-Mail: hL)du,,t24e�tV. Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENT L CO S ION LIEN W fNFOR ATION: DESIGNER/ENGINEER: _sol-Not Applicable Name: hALA MORTGAGE COMPANY: Not Applicable Name: W/4 Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: :?'Not Applicable Name: S AA!Ae6 A wy��'�— BONDING COMPANY: _Not Applicable Name: I -I Aa 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. iermit holder to build the subject structure covenants that may restrictor prohibit such )r 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. n en o obtain financing, c"onsult�vitfilehdel or'an attd�ney before commencing work owieCording your otice of Commencement. 10 Signature of Owner a/Contractor as Agent for Owner Signature of Contractor/License, Holder; ::.. STATE OFF IQQA STATE OF FLORIDA, COUNTY Sir, L�1 = :. COUNTY OF The fooing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 3.rgday of 730% h 2011 by this day of . 20_ by n-�TNe5 Wynqv� Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced -% P% Produced (Signature of Notary P, b' „ INAMARIEGNENS (Signature of Notary Public -State of Florida ) � * rR't'•:�; MY L:GMMIBSIGNIi GG022023 , •� '' � / Commission No. (,G r pecemberr18,2020 Commission No. (Seal) " $' BondedThmNolery Pdboundewderc REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE,MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.:3/2/17