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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a 1`S Permit Number: 15d� -43d� RECEIVED JUL 21 M F f- Building Permit Application 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: Gas 7-v .�.nor -es.r.. �.-� r ,:e Y r r,>,F•i �.,+ rs 7 1 e•a,..,a-.-�r.�-... ..:._ ..�: .__ . . ..v. .. r €._. >.s ._mt�... -.CEcrc.E�,,�_..+:!?-u,d�}:..i..(.....r t._.m:.. .,.._._...*1_,_r L'r�. i.r...�t.. ..�.`�.. Address: Legal Description . /1s i Property Tax-ID#: U " Gr/- 3 Lot No. 2- Site Plan Name: Zvi / _ej Q Block No. Project Name: 1/U/_S Setbacks Front Back: Right Side: Left Side: il:5 T.�Ii.�D�b:.. :r" � ,:i�r t � �5-. t t��r.f,•�- *'`{r"3.tr..;yF 'r ti•^r� u'ry tr.:£`-Sa" P-t}, ,'��,`r �.�f�i,�}!.,• �t�>�'—%-.�s`Jixx c.-..�.�,ty'z.r.�j L:�l�.i1:lS.wr'S-t��'Ya..�Yi.�4�'Y_...$�1�:�«S'+YG.�Hi�t`Yli'�a...�r-i �) tiil.4f_�P.i:_ti'\..'.t_K.l]�T4Pa.R,�.`i��fPt l�rif'f�'HtTKi�.11����YkS�-�1?J�-71�ff �i1 jh5': �i T(-41 Z1b 4,2h ✓> S�-.�� � — 2 a0z6-f 7b let n t 5 //�tQ -n .4/1,o. ?j.;R 7, r_r'����Sr wnff_;S�"..:3�;�tik,�U�S_3h',��:�o .�,5��;ti22 -4 4>+ ,'P--5 z3"�'`l ."3 '.F`':i�'4t ,it itf� "' `t< ;� e Wit;':r f C: jf 3}:- ..fr':�S.�P'tr.!..-.yr-ct` y t •:i, 3 2 t f { r- t "r t3. f3 sa);, xhRrtYat' h ,ra Yri <srf ��ONS�'RLiC�:ION�I�VFORM�IYI"®N:�`�i ,'r � � .y) t`.$.:�g,}�h,a 3.k3�k'v,.,r;.�,t.'+��x;t1 7..°i;t, 'rttrrr�:F:n.•: F'� x,�,:-�-��xr. exz-,-t r:ic"'�.tC::.is '.',a'>Ir..2..,.;.'�F•r<a`r�- n�_;k, ,'} .�F'..f: ., }tr Af+..., tAt J, t. .{.,;t, Additional work to be performed under tis permit-.check all.that apply: _Mechanical _Gas Tank Gas 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: _ r`�; a - ����� QQ " r r44i:dfz m i r{ •s r� f't' i 7 'k_x`;�5:'.F7.Y.i.tF r �,E_�-(,:!-.K,T.._Jy.,r_._E7 .e,i.rMS-.z.Fs...!ri,r,,..s�'°.,a".1.iYi4r.r.r,rh-3'_L.�,G:r. ,ro._;4S.riafr.,, 1r'�rJ°'t4t.n,s iwS�1-'-ir2-YkX� d-.t.��ttfc:,pa.,Fests;} ��,��Cv2+'J'O:.�,N.!$�Tn,R.s..�z;sd;C,iP. .OR>rr�cffa�1.i.+S E.fia`;fti'�r t"�-. �!1ik.-s.;Kc.,,a:r�.:r..1 .-r.Ts,�•i,w ,� -'-,sb dY41$W�01— Name :Name ti tirFg�thy; Name: Address: - tea, / Company: 2911?.Qnf Gu r City: /-trig State: Address: i3 v/ , -gla,v4& 4 Zip Code:_3q)H Fax: City: /�r•'T A.ere-r State:/ Phone No. ))`L rP/6 &�2 3 Zip Code: 3/9 hl'o? Fax: 2 7 Z_ - W f:YMP E-Mail: Phone No: -633 -07VO Fill in fee simple Title Holder on next page(if different E-Mail: / V * v� from the Owner listed above) State or County License: .r.7 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. i v;r 4PN ,i:> tjPPMN �ALw+rONTRU �= I tLl 1lVINF©R Ar;I, Nt _ .� r3� �j t'� .t[e �nt,f���•..ts3'i" t, '� l Srt.".4,..,-_ 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 1 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 Countyy 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 Cf ments to your property..A Notice of Commencement must be recorded and posted on the jo.bsite re th fir ection. If you intend to obtain finan ' c suit I lender or an attorney before men n - k r-mcQLdfing your Notice of Commen fent I Signatur =ofAgent/- i Lessee aator/License Holder IDtSTATE � STAT=E COUNTYOF COUNT OF ,Lc��; The forgoing instrument was acknowledged before me The for oinginstrument was acknowledged before me J'f thisg2,L day of_�'�/1 ,20by this day of t.1 204-1�:_by L G / . (Name o7person acknowledgin ) (Name of person acknowledging (Sig ature of Notato cjQ (bHAqL ILF.Y (Signature of Nota Pu lic- r .A MY COMMISSION#EE217600 MICHAEL MILEY Personally Known Pro4"W9&W%i20 Personally Kno _• �I l ' Type of Identificati I �el Type of Identifi uce EXPRES My 1". 010 Commission No. (Seal) Commission;N I i REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE j COMPLETED Kev.7/2014. f I 1