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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �5' l 7;�, • /S Permit Number; _ Building Permit Application RECEIVED Planning and Develoixnent Services MAY I ? , Building and Code Regulotiorr Diavisbn 23W ifiYgmriia Avenue,Fort Pierre R 349&2 Phone:(M)462-1.553 Fax:(772)4162-1578 Commercial Residential f� PERMIT APPLICATION FOR: To Seled from dropbox, dick arrow at the end of line IMPROVEMENT LOCATRAI: -#- Address:_ to-2 ZS �Ci✓✓�v� �� t n�� `a �1 r� n ce -, ��r F, �L L�cJS 7 Legal�rDescriiption:_� L i� jJ�s t(�11 i t L# t �(/ � �L n f 21 �'A,.a I k Property Tax ID ll:_14s ( I - �U 1 - C) l q Ll-_ 1 - `i Lot No. Z_J Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: WNM,01P"TMl OF WORIG. ern Du �,��s fi,�5 � � �► ,s �� 5- W V\/)LfA(- Additional wo to rin under this permit- a app : HVAC Gas Tank ®Gas Piping _Shutters F]Windows/Doors DIElectric Plumbing FISprinkiers Generator "oof Total Sq.Ft of Construction: -7L4 Lo Sq.Ft . of First Floor: Cost of Construction:S�Ll,y a") Utilities: Septic Building Height: CONTRACTOR: Namet3L.0 Z-' I l to . , / 1 1ru_>L Se Ism Name: Lin- + �-Cc Address: to 77 2_5 3 OC-Ei4in t),t ,, LD Ll I Company:J Y%Ar,catC "n Ag_ (:,nk,7� State: 'Ft, Address:3g57g SW ?1 — o Zip Code: 3 i-I5 S Fax: City: cfI St , r _State- Phone No-_2 S 7 - to-2 ( - '54-- Zip Code:3 S.3 Fax: 77,_7 ��j q9 1 C E-Mail: Phone No.'7?; -22.2 !8l _:�o F'iH in fee simple Tide Holder on next page I if different �j E-Mail: TCC 0✓1 C from the Owner fisted Www) State or County License: CCC 13 2, © '�►� If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. - I DES( GINEER- r Not Applicable } MORTGAGE COMPANY: ^Not Applicable (� Name- A c- �1 nt ,I Name: Add 9(4 s w �I WvQaC- sic S f? h1i Address: CG Crty Matte: rs„� Cly: State: Ij Zip: 349 Phone: -7'1;.•7 -gFrS !j Zip: Phone: FEE SIMPLE TITLE MOLDER: Not Applicable BONDING COMPANY: Not Applicable ij Name: ;; Name: Address: ' Address: jl C"irty: City: Zip: Phone: I Zip: Phone: f d 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 holler 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 structtire.(Please consult wrtdh your Hbmme Owners Association and review your deed for any nnfticthons uftich may apply_ In consideration of the granting of this requested permit,I do hereby agree that I wd,in all respects,perform the work in acxorrdance with the approved plans,the Florida Ituuilding Codes and St.Lucie County Amendments.. The follloucimg buuilldiing permit app5cabom are euenmqpt f m undergoing a full)covocnurrency rem 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 or recording our Notice of Commencement. s signature 6f U63der STATE OF FLORI i m i STATE OF FLORIN,,1 COUNTY OF _ COUNTY OF ir m lfrie o i meat was Ern (i The forgoing instrument was admawledge d_ r� this day oO 77A 20 J .� 1; tihis day of I 1 - "20 /,S z A (Name of person acknowledging) �! (Name of person acknowledging) (Signature of Notary Public-State of Florida} II (Signature of ry Public-State of Florida !y Personally Known OR t tifetation Persona! Known OR Identification V, Type of Identification Produced , Il Type of Identification Produced " " Commission No. (SeaQ Commission tido. (Sealy h i Ci Revised 07/15/2014 REVIEWS FRONT 1; ZONING j SUPERVISOR 1 PLANS ` VEGETATION i SEA TURTLE MANGROVE COUNTER REVIEW REVIEW �, REVIEW ( REVIEW REVIEW REVIEW I� DATE INITIALS