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Home My WebLink AboutBUILDING PERMIT APPLICATIONF• rVA: ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��pp Date: Permit Number: IRS ©C.ZX-�1 Building Permit Application Ff e o Planning and Development Services /��l 1Qs Building and Code Regulation Division Sr 4117V Deoa 2300 Virginia Avenue, Fort Pierce FL 34982 /Coin! Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ✓ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line N i IED B L. PROPOSED IMPROVEMENT LOCATION: - Lucie Coun Address: 00S" OGG. \C., P)ue- J �bc P kerc_Q Imo_ 3L-iO�5 k Legal Description: L,-.,y.P—L 2br)c �>r\C-- O \O -%\\L k�A- A LJnT \3 MFiP 13�bIS� L_h'e ?3ssq -L( a S �sG(o -� ks I o� 2ag Property Tax ID #: \ `)ON bdb - S Lot No. Site Plan Name: Block No. Project Name:�)C7Lz ( \ Setbacks Front Back:_ Right Side:QN1 Left Side: DETAILED DESCRIPTION OF WORK: S C-ee e-% �i1C t bSur2. CONSTRUCTION INFORMATION:' ' niona wor to e errormed under this permit- checK all apply: 11HVAC Gas Tank Gas Piping _ Shutters ❑ windows/Doors ®Electric OPlumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ ��7 Utilities: Sewer Septic Building Height: -OWNER/LESSEE:,, _, CONTRACTOR:.. Name_�..1 ?'Fl`�DW(le,, MF)f-C � bj,;Ji :Nartme, fld_ L>.)e- 11•t4G� t�.�.r. - ;Company:-WoQ PVorr 7nur� )nc. lit do -Es Alums Addres- i (b'iOs-: 6C AC, oL -c. .. suy:fr4_ e_ciaG-[o ` /did. City: Veil) ReGC.I,-, State: L ZipCode:Z- 1qS\ Fax: Phone No. Sk? -S-)g S$Sj Zip Code:�!)Zci (i d Fax:Tiz f- 7•�w E-Mail: Phone No. Sol-?jL(L( Fill in fee simple Title Holder on next page (if different E-Mail: 0bW uMch i � at)\ . CAM State or County License: �o��t i \ from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. M SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable Name: . - _- - -- - BONDING COMPANY: _Not Applicable Name: Addt'e's's: • ' ' 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 vvork or recording your Notice of Commencement. Signature of Owner ssee/Contractor as Agent for Owner Signature o ontractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF Pcyear- The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this -LiNayof 20_1&-by this _U�ayofJZ)9� iry}_,pr 20�g by Y_ e l-L tlPrlry�rr�� Namdof king statement a(k�rlC�ul Name of person mm tatement person Personally Known OR Produced Identification _�, Personally Known ✓ OR Produced Identification Type of Id ntification Type of Identification Produced wL Produced Signature of Notary Pu }c- Sfatq Pf Florida (Signature of Notary Public Late of Florida) Commission No. 22Zt.1 .RY•"'tATHLEEN Z2eZ\ :A'•.KAI`HLEENLU mono. a`• 2om ioMMISStON#MK a' EXPIRES EXPIRES:MayCOMMISSION@ �R.•' f 60MadlluNam: eosRHordeTim Notary REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17