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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO M ST BE OM'.D FOR APPLICATION TO BE ACCEPTEC Date: Permit Number: �a Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: bi 0 O Building Permit Application SCANNED BY St. Lucie County Commercial Residential Legal Description: 33 �?Y ry0-r-4A-7' %a,e-T 0r- hour Loi- r/t3e," Zsd F'-,0-YQ 6 Al bFado -7—v I-Wco cd g Ly6 In/ U-fw,✓b AD i4_o D/xr& f#wr Lon 9138-/�g) Property Tax ID #: /' 3 /-5O - &0 "T- — n� U - Lot No. Site Plan Name: A14CO Zd Block No. Project Name: ef.)9 Zo LI nF,4 et92 POler Setbacks Front Back: Right Side: Left Side: �/LEGY" A PiCC-r,+5 CA-2oG/.y14 rz.T / 9 /XSD r c�i-,r-� Z.or /S 1'DISCoonr .Sro2H�Y �0� 3oa-�' _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction/:J p, Sq Cost of Construction: $ 00 ,, Utilities: Ft. of First Floor: _Sewer _Septic Buildin Hbt;, ®WNEEi/LESaEE 5 C nsL v P 11- 1 . v w, Tk'rvP &'eY WM9` r1 « n� +rY - 1,.x i,. '3 CONTRACTOR ,<y 'sF. �,• ..F.. ... .«M. . F` !'r ,eR A zk Name LAU/Z 1-c 0A/%nca4, Name: Address: Company City: Stater Zip Code: Fax: A Phone No. A-F �, Address: //-7 Q11C?Wn .4AfAJ G%� City: -:P Stater G Zip Code: 3Y F =/ / Fax: NIA Phone No 'T% 7- ®A S S of S % (aFill E-Mail: A41A, in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail S A (es F I rsr t aw Low State or County License Lh,(__ / Q SQ 6�.3 Z If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. Name: og 41s Address City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: h719 City: r — Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: i l &_ Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address City: 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 nrL n rnrnrrlinP ,nnr hIntirP of r-nmnnPnnPm Pnt. L ssee/Agent na ure of OVRI for/License Holder nature orF STATE OFA STATE OFDA % ` 2—A COUNTY J C\� COUNTY The for oinginstr ent w s acknowled a re me 2 by Thefaraceginstru en^ cknowledggd��fore me this ay of 20 by this, day of ©r\ (Name of person acknowledging) — M A (Name of person acknowledging) Pv (Signature of Nota Public- to of Florida) (Signature of Not Public- State,of.Florida ) i.,.,.,, Pe 0 w NGEI@I'�Fj u ntification anon Person I ,,� q b9NI biVP Ty e_ t c ublic -State of Florida Type o I : rlNatary Public -State of Florida j P[ .o OMMISSlon ,y FF 23473n Produ C w Commission r oc 99evon •,, <« ,' i eomnrEx 27.2019 eon D ros May ' t 9hNa0aulW Wary `s rF s My Comm. Expires May 27, 2019 ,°ink' V y COm BlidedthroughNationalNotary/�,4 I) COm 151 eal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW IEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED