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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION201 51 241 2 01 5 1� g 1 �, ALL APPLICABLE INFOMUSE E COMPLETED FOR APPLICATION TO BE ACCEPTED Date: L? ' 1 SCANNED Permit Number: St. Luce County r _ "RECEIVEDMOP Building Permit. Application DEC 18 2015 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 t Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: C� .Address: /12 I d &[ ,q Legal Description: PropertyTax ID #: 3�1D �i �O i ©3.22� — © Lot No. Site Plan Name: Block No. Project Name: /Vl P_ 7"R n 674 Setbacks Front Back: Right Side:. Left,Side: I DETAILED DESCRIPTION OF WORK: kJd 77n - GU,DA,PA�/1 A r R CONSTRUCTION INFORMATION: III L_JHVAC I I Gas Tank UGas Electric ' ❑ Plumbing ❑Spr Total Sq. Ft of Construction: Cost of Construction: $ 4z Piping U Shutters ❑ Windows/Doors nklers ❑ Generator ❑ Roof S Ft. of First Floor: _ Utilities: Sewer ❑Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name S.5/UKI�q Name: Fesm,IiV s.,So/f Address: i 3106 Ao 9 &Ae Company: City: !OiP/te. State:zS/ Zip Code: V�>P2_ Fax: Phone No. Address: 9YS ;2e,� TN r7 City: A49d State: Zip Code: --?.? YD Fax: Phone No. .S4 ) Z/2 y Z E-Mail: Fill in fee simple Title Holder on next page ( if different fro wi ft9w,er listed above) E-Mail:1j fh A G n_ State or County License: G` J DD pC) J Y CJ If value of construction is $2500 or more,.a RECORDED Notice of Commencement is required. DEC 2-2 2015 HESOURCC5 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: Address: Address: City: City: Zip: Phone: Zip: Phone:' I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Counttyy 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 of Owner/ STATE OF FLORIDA STATE OF FLORIDgg,, COUNTY OF 1Pi4 )4. l��q/LL COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this/7 dayof a7eeewe" .20jLby this/-?dayof t2ece.).da. .20_bEby 1P2tciPN 44sg!/ti1S 24t,w J-1JAler1, (Name of person acknowledging) I (Name of person acknowledging ) of tW u23, Revised 07/15/2014 Commission CS NEEl4Wttda (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW RE IEW REVIEW DATE COMPLETE INITIALS