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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMI_ "ED FOR APPLICATION TO BEACCEPTED Date: IL14 SCANNEDPermit Number: BY 9 �+� I .. 5t, Ude County Building Permit Application _ 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: PR®POSED INPRIMAINE, LOCATION: Address: 4y0% Pm5s1.e.r Lan) - Legal Description: (Ord ; na l G la d.t s 811e, (o Le,4 5 ( o r 36 3 `1 Property Tax ID #: -2y3r4 - R Oa -- 0 43 -o O O -9 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DE/T�AIVED I ASCRIPTION ©F VU; K4,i7 laCq- ✓JQri1 eje4r.cn Dane,/ ; 4 10U0eJ1,y /cedar. n n 60r (- , 1�► 4,,1) at , 0 n e,vv rJCd el a U* � e--� . al 5 hG // CONSTR!l1CTl®N 1NFORMATIQ N: Additionalwar to a performed under this permit- check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: -Sq. Ft. of First Floor: I Cost of Construction: $ doa Utilities: —Sewer _Septic Building Height: ODUNERLE�StiSEE: C®Ns RAC«�TLO.R: Name Na�-3Gr,al A 5So!�Z-M) Name:" Address: Company: � W M C City: nA (V1'M State: _IL Address: Liy 1$ Y!'es56r Lr k— City: V� Qx CA- State.-Vt- Zip Coder 1 %13 Fax: Phone No. Zip Code: 9'\9 $ Fax: �— E-Mail: Phone No. "�"?�--��ka-5`Z5a- Fill in fee simple Title Holder on next page ( if different E-Mail: O,u,,rr-,e-'1 y\Cne-1- State or County License: (, _79q from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. �PPNTAL �nNSTFtkl1@ LI N_ LAW t �lVl TON: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: 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 work or recording our Notice of Commencement. t Siof Owner/ Agent/ Lessee cam' a of Contractor License Holder, STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ' COUNTY OF O The fgrgoing instrum t w� cknowledgedbefore me The forgoing instrume t wa nowledgecj brfore me this day of 20� by this day of 20 y ale erson acknowledging) ( f person acknowledging ) (Signature of Notary Public- t Florida) (Signature of Notary Public- pie offlorida ) Personal) Known OR5Rraduced'11denf€"rft`at CAW + �•`RV PL Type Identification Produce Personal) Known �! __ OR Produced Identification a of Identification��P'ro d p y �4i of P Fn, State of Flan i :2 d T - C m..DAWN Ex fires Mar 22, 2017 Commissiori No N �S rmission ,wc MILONE a `OSPRV AL/J� i . ��'^ : Notary Pu lic - ate of Florida mmission No. �•�. y Comm. M� Mar 22, . # EE 877571 SST P• OFF`°`�, Bonded Through National Notary As 2017 •,P ;.fY` n. f; %:9T �• Commission # EE 877571 ,oa% <_•�.«, Bonded REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE , c MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE ; COMPLETED Rev. 7/2014