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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �! �7 n. Date: Permit Number: f�V 001. , +s Building Permit Application JUN 16 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 q/l Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: FIR 111,611,PMEMENT LMCATI:QN: Address: 70 3 &,,.,,A Lh Legal Description: .l A �- L/C Property Tax ID#: I//-OZt{Z-GtJI)-1 Lot No. /2 Site Plan Name:,W/Ah".0 A&71 Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAIiLED DEQSCR+IPTION OF WOR- : CONSTRUCTION I'N'FORMATION: Additional work to be performed under this permit--c-Fe-Ek all that appy: —Mechanical �as Tank SNas Piping _Shutters _Windows/Doors —Electric —Plumbing _Sprinklers ✓Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ Utilities: Sewer _Septic Building Height: 0 ER/LE=�SSEE: CONTRAM+1'OR: Name Name: Address: Company:� //ems City: State:_ Address: 3--132--oJ �I�i� Zip Code: Fax: City: STWz tn/: I Stater Phone No. Zip Code: 3Y95z 7 Fax: 7Z?--2k7--34(5'(a E-Mail: Phone No 772-Z97--c/336 Fill in fee simple Title Holder on next page(if different E-Mail e- ST v / a.s-e P*l from the Owner listed above) State or Coynty Lice se If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SIJPPLEIUIENTAL C®NSTRdl1`CTI© IEN L�VV IN'FORI�IAI'ION: DESIGNER/ENGINEER: _ of Applicable MORTGAGE COMPANY: L,,fTot Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: —of Applicable BONDING COMPANY: of 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 commenci work or recording our Notice of Commencement. Signatur of Owner/Lessee/ gen Signat' Confiria'ct /License H der STAT OF FLORIDA ST TE OF FLORIDA COU TY OF �d' +�- COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this (17 day of L&A4 ,ze_ 20 l by this(Z day of JLA_r-1,C 20_L,5"by (Name of person acknowledging) (Name of person acknowledging) (Signa re of Notary Public-State of Flo ida) (Signa re of Notary Public-State of Jori ) Personally Known a� OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced 0"-- 'Tf T' Produced � -' _ YLi I i f#L`.JOHN YU-rfA D.JOHN h1Y COMMISSION It EE116915 MY COMMISSION#EE116915 Commission No.6ir; /�(p�I/ W (SHatks:o�co1�11,z°1s Commission No. C���6�/S �, a� rz (SB s: 11,2015 FI.Notary Discount Assoc.Co. Fl.NotaryDiscou¢t Assoc.Co. - I8CO3-T�:7TARY REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /2014