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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONv (ALL APPLICABLE INFO MUST BE COM ,.:tTED FOR APPLICATION TO BE ACCEPTEL--✓ � t — Our Date: SCANNED Permit Number: L � St. Lucie cie County _ Building Permit Application R ECE:76 ED Planning and Development Services NOV B Building and Code Regulation Division 2015 2300 Virginia Avenue, Fort Pierce FL 34982 ERMI C; Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ResidjW PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: T ✓% 3 Ll Legal Description: � pper�,, Property Tax ID #: —Jc[L! "con, % — W0— Lot No. Site Plan Name: Block No. Project Name: Lf4o ah p " Setbacks Front .� a " Bac Right Side: Left Side: �DETAILED DESCRIPTION OF�WORK: � � _ �_, , . �_- . Asrne- /.. CONSTRUCTION INFORMATION: e AMU LIUI 101 worm to e orme un ert ispermit —checka apply: DHVAC Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors _ 11 Electric 0 Plumbing Sprinklers Generator 1:1 Roof JJ n ^ / Total Sq. Ft of Construction: �L9�yJ� �/ S� it % LCof First Floor: O Cost of Construction: $30 736o, DD Utilities: Sewer ElSeptic Building Height: OWNER/LESSEE.,° CONTRACTOR:q, Name Name: Address:L O /� Company: iZ(>i0 City: — t'� State: �. Address: �� City: State: �y� ZipCode:_��/�� Fax: Phone No./ Zip Code: �� IrO Fax: 'a Phone No. JJI�///�� % E-Mail:�P.�A`% © �°/YIGY�%17tQ2/Ir u4 , �/J"777 E-Mail: !/5�7�!'�AISK/iillllAi .(�aJ» Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. /II UPPLEMENTAL CONSTRUCT rm LIEN N Name: Address: City: State: Zip: Phone: MORTGAGE COMPANY) _ Not Applicable Name: //JJ Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLD R: _ Not Applicable BONDING COMPANY: Not Applicable Name: fit' -A 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 Ste 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 ,•r,mmencine work or recordine your Notice of Commencement. _ Signature of Owner/ Lessee Agent Signature of Contractor/ 'cerise Ho STATE OF FLORIDA STATE OF FL RI COUNTY( COUNTY OF The ding instru Nis acknowledge be ore me The f going instr m was acknowledged before me this day of ✓ 20 �y this _ day of 20 4L by %•,�� D-� �� .off Fi9� �4-7�`f (Name of person ackno ledging ) (Name of person acknowle Bing ) ALv� (Signature of Notary Public Late of Florida) (Signature of Notary Public- State of Florida ) Personally Known V OR Produced Identification Type of Identification.Produ71 Commission No. Revised 07/15/2014 FRANCES DONZA rISSION 6 FF014070 ES: July 27, 2017 Bonded Thm Nosey Public undemnion; Personally Known O Type of Identificatio cESDDNm ?� :r MyCOMMISSION 9 piNSS: d0IY�7 2017 Commissio No. '• EXPIRE2017 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW RE IEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS