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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION'All APPLICABLE INFO MUST BE COMPLM eu""rOR APPLICATION TO BE ACCEPTED ^ J Permit Number: Date: =RECEIVEDBuilding PermitApplic 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 Residential PERMIT APPLICATION FOR: �[�, rJG ou �oL�J c� t�5 •. Address: eq 19 Legal Description: -- - Property Tax ID #: -' ©� r? 1r Lot No. Site Plan Name: fl�//ate Block No. Project Name: 1�0_K aA-_6_1 Setbacks Front Back: Right Side: Left Side: g AC101itional worK to be perrormeu ri -ert this permit -c ec all that app-� V _ V 8 Mechanical Gas Tank _Gas Piping Jhutters ~• Wmdows/Doors 'Plumbing'' _Sprinklers' —GeneraEor, _Roof Pitch .Electric.. — . ; .; .,.�..: c,.., ".•l• y �".%`�.n..% ... .. _ Total 5q._,Ftof'ronstruction::,. :_ - laws•nr�T%.om.�r.•rns�a—v.os�im.w+vi'+� Sq. Ft. of First Floor. '( •:�ti,:. ,nsir : da sr CostofConstruction:_$ +� ` (��d Utilities: —Sewer —Septic Building Height: Name i6�tL C—C A,e Nam OS i Lth - CL! ,o— Address: / r) t/ �% Company: City; elkl,4e-4 State:�st Address: Zip Cad Fax: City: �fo4�� State: �q Phone NO! J' �6 /- 3 SS Zip Code) 9 Fax:' E-Mail�h�12 /X it1 0l w. loaf Phone No. ?-7 Fill in fee simple Title Holder on next page (if different E-Mail - 9!Bo 6 7 (E A04 � rn from the Owner listed above) State or County License O Z If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required. Name: .-.- — � • --- Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: — Not Applicable Name: MORTGAGE COMPANY: — Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: —Not Applicable Address: Address: City: City: Zip: Phone: Zip: 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 commencine work.or recordine vour Notice of Commencement. Sign 1r Owner/ Lessee/Contractor as Agent for Owner Signs a of Contractor/License Holder STATE OF FLORIDA /)/ /i /14 � N STATE OF FLORIDA COUNTY OF COUNTY OF The forng instrument was acknowledged before me The f�rg_oing instru ent/was agknowledged before me hi./ this. day of jt�o1OPM P L " 20 /% by this _ day of 0 u , 201j by m U [ fJS�i1/I VeccA/"0 y L //o""n (Name of +DMedgingsli M cG 143790 (Nam f p acknowledgi My Commission Expires ber 17, 2021 •' hgo Stptq of Mrido .(S' nature of Notary Public- r'dWGreerShareth Cdn niislon FF 962709 (Signature of Notary Public- State of Florida) Personally Known OR Produced Identification My it y9y1812020 ersonally Known 0 Pr4��0 _ Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW DATE g�E�lREVIEW RECEIVED DATECOMPLETED Kev. //LU14