HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFFOf MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /' �' Permit Number: /f_5 07 0 O
RECOVE®
Building Permit Application JUL / 1 2015
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
PERMIT APPLICATION FOR:
J'a rn es ��Lr
Address: 7I9 P D n/, I� r!/� P5/ / I,4
Legal Description: '),®A 8 uy I\ew- V e-t L►- Gw , /_0T J:5
Property Tax ID#: W4 �D��� �0.® 7 Lot No. 5,
Site Plan Name: Block No.
Project Name: nu rlit V
Setbacks Front BacAW Right Side: Left Side: r
Additional work to be pertormed under tis permit-check a 't at app y:.
_Mechanical _Gas Tank _Gas Piping -Shutters 1' Windows/•Doors " 1
_Electric _Plumbing _Sprinklers Generator _Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor,:.
Cost of Construction:$ �0 Utilities: _Sewer _Septic Building Height:
Name9 CLOl e-S `#- 140- k) Name: °
Address:.5?FO YeLr b 'a y� 4 iY - Company:
City: .51 StateJ§�bb¢ Address:
Zip Code3 Fax: 4 City: State:
Phone No. f a 7�� 93 Zip Code: Fax:
E-Mail:,` esW 411 e 734 [�eom C'Q�5%(�1Je�' Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
Lvalue of construction is 2500 or more,a RECORDED Notice of Commencement is required.
DESIGN /ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name:'l i7,`_5 ;1'70 rea ,04) Name:
Address: -1 Weir/��S'®rsn4s Pid Su���fo6o Address:
City:JVi wocd.. State:� City: State:
Zip: i Phone -j39 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not 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.
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 be recorded and posted on the jobsite
before the first inspection. If you intendto obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement. .-
_ ,
.S�igr�atWf Owner/Lessee/Agent Signature of Contractor/License Holder ,
STATE OF FLORIDA STATE OF FLORIDA
COUNTY-OF -4, , c ; )f f -) COUNTY OF
The forgoing inst ument was acknowledged befor �r The forgoing instrument was:acknowledged before me
this ! day.of Arlt lq_ 20/) by this day of ,20 by
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(Name of person acknowledging) ;&m (Name of person acknowledging)
� dZ=
C
(Signatureo otary Public-State of orid "' (Signature of Notary Public-State of Florida)
Personally own OR Produced Identification Personally Known OR Produced Identification..
Type of Id nti a ` n Type of Identification
Produced /hC Produced
Commission No. (Seal) Commission No. (Seal) t
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW - PREVIEW
DATE
RECEIVED
DATE
COMPLETED
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