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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j Date: J �� ��� Permit Number: , © Building Permit Ap plii4caVon RECEIVED Planning and Development Services Building and Code Regulation Division MAY 2 c 6 2015 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line'-1A�Mpda4,N 3 6r � �.. PROPOSEQ III�I�OWEIII I.00ATO; ., as9,f.' Address: _,. .. �r�)(o Lil1MS I A )AA polaq-44141x: L'Oty;,-- Legal Description: Property Tax ID#: 33 Z2 - 707- 00 V6 00O �7—___ Lot No. Site Plan Name: /I4 Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D TAI � LAR QESCR[PsTI ON WQ�,K i 1,3 ;f,9 ., s..,1 . ..E� im " . Pl dvh 6� F 4pes s i sI s'�' "C4NSTRUCT)QN INFORMATlO(V �g9j+ ,��� �� ,,j(�z�r IsFiL�g� �), x,4i". 9�1E ;.��� it 3xFs€ �➢-,4 n.3��tE��.��€�z.33Ek„ .3, E#, bj,.�.�� F �,I.P ..4s�., .e''„ 3 ,,. z.f.<. Additions wor to e e orme un er t is permit-check alT� t appy: HVAC Gas Tank Gas Pipi "i Shutters n Windows Doors p g F Windows/ Doors Plumbing Sprinklers E]Generator 1:1 Roof Total Sq. Ft of Construction: � SQ. Ft.of FirstFloor: Cost of Construction:$ Utilities: Sewer Se_ptic Building Height: !' "N �,. BO NER/LE� hE�y f 1Y� Ipp .,�a f'kt.j . £C, ff 4 Ax � Name_ ROM .:1414 Name:��,/���4y1/.�'��"��✓ Address: A916 L.;AIL. Company: ,/l64&ZZ/Ts &W'eAi/_ City:e6A(Iiki.wwr� State: 1 Address: Zip Code: r Fax: City: ��/tl� State: Phone No. ��I - S�y� V3 Zip Code: -. - r Fax: E-Mail: Phone No._ Fill in fee simple Title Holder on next page(if different E-Mail: y�j uj�j�i)yl1 from the Owner listed above) State or County License: C',FG fThS79 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. �{$ SUPPlEMENT; LC�NSTfCTI( N llEAV1/ NFat11l�l�l, M£�Ar��a�I 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: 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 thepermit 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 4 recorded and posted on the jobsite before the firs 'nspection. If you intend to obtain financing, consu ith lender or an attorney before commencing rk r ec(Jr Ipg your Notice of Commencement. / S _Signature ner Less a Signatu of Conffkt6V/LWe4wf1oIder STATE OF FLORIDA4 STATE OF FLQRODA COUNTY OF + / COUNTY Of= Uel G R— The forgoing instrument was acknowledged befo Cpl: The forg instrument was acknowledgedbeforeme this�iday of M 2,L4, 2,& by r; this)—, day of_ J 20 by 114 Ado Van ot (Name of person acknowledging) 9 me 6 (Name of person acknowledging) Zia- (Signature 6f/Notary Public-Stateldf Florida) �A (SlIture of I tary Public-State of Florida) Personally Known OR Produced Identifi In Personally Known OR PrQduced Identification Type of Identification Produced '.J/W,, Type of Identification Produced D . (XX( Vr 9 Commission No. y (Seal) Commission Flo.&C 135DRgsso 141SPOY L.CONTRERAS oQ NOTARY PUBLIC a Comm#EE135409 Revised 07/15/2014 sINCE 19I� Expires 10/3/2015 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS