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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED r Date: '{ zea LS Permit Number: - 60S3 Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone-(772)462- 553 Fax:(772)462-1578 Commercial 'Residential PERM IF APPLICATION FOR: To Select from dropbox, click arrow at the end of line lolls Address: 3i_4_,0 l U m t Lr_, Legal Description:_SAVAM iUA CLjL 7wb PropertyTax ID#: 'IWaS - "7d�.-O�c"�- -C' 6©- 1 ._ _---- Lot No. oho Site Plan Name: Block No. Project Name: Setbacks Front Back:- Right Side: Left Side: KW 14 S&E 19, i lo11:11workt0benerformed under tis perms —check all appy: 'SOVAC Gas Tank ❑Gas Piping _Shutters []Windows/Doors Electric ❑Plumbing ❑Sprinklers 11 Generator ❑ Roof Total Sq.Ft of Construction: Sq.Ft.of First Floor: to Cost of Construction:$ Utilities:Ll_Sewer Deptic Building Height: Name Z-�0Ntj V A Q A Name: ZM-C-C Lme\ A, Address: 'S_1 • '8 d S-, Aej + Company: C(.eA Fj /4!%L. _74EC N A)b L,pQ)Lc S City A r,Sd �j �Aci h-}s State:hLY Address: IS'7k VIE1WEM z C)If- Zip.Code: 1t"31 Fax: City: );e,-r 54 Luc)c State: rr-- Phone NO 1$- q-11- zip Code: 3�9SZ- Fax: 772- 135- 402- E-Mail: Phone No.777 �' 6) Fill in fee simple Title Holder on next page{if different E-mail:CLPA,,) )S-1 S 0 A6 L• from the Owner listed above) State or County License:0000 S-ff 660 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required, OL6-A £000/3000d 99£-1 -WOai LS:U 9LI-ti0-90 DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: ` Name: Address: Address: City: State.• City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: _ City: City: Zip: Phone: zip: Phone- 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. We o Owner/Lessee/Agent S' S Contractor/License Holder STATE OF FLORIDA STATE OF FLORID COUNTY Of-r Locl(_ tom _ COUNTY OF._... 5� �+-�_16 CWA,' y The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this--4/ dayof OlAy 20 LS this q dayof20 by (Name of person'acknowledging) (Name of person acknowledging) 9nta ( I '�&L �J�� U00 gel 16 (Signature of Notary u�blitate of Florida) (Signature of Notary Publi tate ofFloridaPersonally Known Pr Personally Known OR Produced Identification Type of I d entifi cati, npd—s> a Type of Identification Produced Commission No. g*�. MY COM SI RN,*FF091118 Commission No. w, SAIN=11%WALSH PIH� ril 11. 2038 MY COMMISSION#FFCP'1116 ao 39W63 FloridallotaryService-com mM Revised 07/15/2014 tao�a9a-0ys3 t7witlaN sero REVIEWS FRONT- ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW .REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS ocs-d 8000/6000d 99£-1 -w08d n:3 I; 9 L'_ti0_90