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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1a,%k. Permit Number: RECEIVED JUL 23 20b 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: Q PROPOSED INNOR WEN EMENT L©CATION: Address: 2425 6P22_y 7Gt la 44. Ff Ple14f4 , FL Legal Description: Z!�T/4 ?-, J,,e 6:� za T%7255 Property Tax ID#: � Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION DF WORK: CONSTRUCTfON 1NFORM-ATION: Additional work to be performed under this permit-check all t at app y: _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:$ M5 d, b d Utilities: —Sewer —Septic Building Height: OW�1ER/LE�S`�SEE: ,�CON�RACE tO,R: Name Name: - r7 GW S \ Address:a� �-� y TG�fG GG' Company: City: State: 0009 Address:4" 1VZ,4d Zip Code: Fax: City:, -5�4L��!.e— State:0!::/ Phone No. Zip Code: .5,141*3 Fax: 71.2=2375,47 E-Mail: / Phone No 772 �� IV6 97 Fill in fee simple Title Holder on next page (if different E-Mail 1A1,424/�'�S�•G(�Y7-1 from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Sl1-PMLEMENI'AL C®NSTRaIlCTION LIEN LAU1! INF©RMATION: 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: 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 commencing ork or recording our Notice of Commencement. Signa re of Owner/ essee/Agent Signatxdre of Contra r/License Holder STATE OF FLORIDA STATE OF FLORJDA COUNTY OF Sk- LJc,'% COUNTY OF , 1—yC,1 The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this��'day of�y 20 VS by this a2_day of' Jap 2015 by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary lic-State of Florida ) (Signature of Notary Publi -State of Florida ) Personally Known OR Produce 1 on Personally Known OR Produced Id Type of Identification DEpNNA State of F\0c1 6 Type of Identificat�nio..�n p_� NNp g1VENs Produced L bt�c" pec A6,2p1 Produced 1� "`a,. DEA�1r State of Florida _ I P,;e C,i No mm ExPiies��g5a761 �s, ,, Nota i[es Dec 16.2016 My C° # Commission No. ota�y Assn• Wil,Domm•ExP ��858761 = Dom atK Commission No. ff •o; aUon .oQ` ommissio Assn. ded Zhtou9 a, oma.- Bon Through Nations NotatY ion ded REVIEWS FR T ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014