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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ��7"�� Permit Number: _ RECEIVED JUL'2 81015 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: PROPOSED IN , ROUfMENT LOCATION: Address: GQ� css•s J ✓ Legal Description: Property Tax ID#: `�yG� �i/�. ' 66 6&– 066 Lot No.�' Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED Df�SCRIPTION OF WORK; 01 'OF CONSTRUCTION IN R,10ATION; Additional work to be performed under this permit–check all that appy: _Mechanical _Gas Tank 7 Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ led) od Utilities: —Sewer _Septic Building Height: ®,UVN,ER/LE�S`�SE ;: CONTRAC*�T®R; Name c,le, crus Name: I Address: � �U�7 � '� ��.:,r Company: %��+�n•/ �� %�� �r�«. City: ,� �'�if�- �L> State: JL Address: e ,cam Zip Code: Fax: City: � is', State: �G Phone No. r77? 6J66 41,PS3 Zip Code: yY1 Fax: 77p – ---YK37A2 E-Mail: Phone No =-S6'd Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License 4Z6 022 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Sl1PPLEMENTAL CONSTR,l1`GTI©N LLEN LAUU INfQRI1/IATIO'N: 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 work or recording our Notice of Commencement. Signatu of Owner/Lessees Agent Signature f Contractor/Li ense Holder STATE OF FLOR19Q. STATE�.Uc� COUNTOY OF FLORIDA R5�, L-Qe- COUNTY OF 7''ff The forgoing instru_Merit was acknowledgeri before me The forgoing instrument was acknowledged before me thisag day of 20_ by this ay'� day of 20 5 by XqN (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary PubTic-State of Florida ) (Signature of Notary Public-State of Florida ) Personally Known OR Produc ��fr � r`4"a�6 Personally Known OR P.�osfeej6it�if � a Type of Identification °�' OSP •°-spa ec�6' Type of Identifi do OE State° p16 < eub\ExP`�e5EE�5a16Ps5� Produced ,�V'P�e%. NotacyPuitesDec�8761 Produced ay 85 .••;,`auoc;�-,,,Myr°mm:\Ss�°Na`\p°a�N°� 5a°• `* .'MY�0 mission#.�E,Notary Assn. Commission No. .. •= G°� ` Commission No. de6Jh\Jo . REVIEWS FRON, ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 712-014