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HomeMy WebLinkAboutBuilding Permit Application -- r T ALL APPLICABLE FO M ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: r C\ l Building Permit Application r 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 _2K PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMP.ROVEMENT:LOCATION -, . _ .- Address: Ic1g7J, uAMUK IhGC- BLVD Legal Description: NAKeoUf, PIbGC- Property Tax ID#: To�b" �"(����QQr� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED;DESCRIPTION-OF.WORK: P.EM&ME TUg LJiP lA 6 GUeST $A(TN— (��L_OCPVTE VAN in D6,4r, ApD CAN iA) 596V62,R64IACE �x�/fJs7 1 AJ TN 3 v RE 1-0 CATS ur4-nr l L! 9 ADD r,41V mul 590LJC AMA.66 4x0050 FAA) .CO.NSTRUCTION INFORMATION itiona work toe e orme under this permit-check a appy: aHVAC E]Gas Tank ❑Gas Piping _Shutters Q Windows/Doors 9 Electric ❑Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ �, Utilities: Sewer Septic Building Height: .ONER/LESSEE CONTRACTOR Wy, .. Name )LSA Name: ; TrW, EA)6&JV AfAJ Address: aV09 66P, LAKES b8, Company: tJKo�-rc L,EaTktcA-1 Cowroalve SNC City: RcrkK Crry Stooa��te: O-r Address: 7W0 GiJIO�I PL Zip Code: 9` 060 Fax: '7?a P& a�� te�-T City: 1'o2T ST l-uLIE State:FL. Phone No. —77oC 393—©,S53 Zip Code: 349.52 Fax: 77,R-g7?—c&-5Y E-Mail: Phone No. -M— 370- 5-2515- Fill -25Fill in fee simple Title Holder on next page(if different E-Mail: DCi/4W C-J GAV-, nJ,6-T from the Owner listed above) State or County License: 1✓0000 347 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION F. tJ 4F l .. ...t ._.'.' ,.i "Ka •:c.i ., _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 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. JJ.6'�' S _Signature of Owner/Lessee/Agent Signat of Contr or/License Holder STATE OF FLORID��LUC 1 COUNTY OFFLORID �j ,�N6 COUNTY OF /�G° The for in instru �t was acknowled ed b fore me The f ing instrum as acknowledged'.,b�ore me this �day of 20/6 by this �i�day of fi� v 20 rby 1 � (Name p rso acknowledging y (Name of erson cknowledging •,VIII �� (Signature of Notary Publi State of loris .� (Signature of Notary Pub c-State of Flor a .o O Personally Known OR ProducetNoi Personally Known V OR Produced Id 'it�n� Type of Identification Produced 44 Type of Identification Produced O 6 0 2 R Commission No. (S �D.. �P Commission No. (Sea 00-0. a, o Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE CIOM PLEI•E INITIALS