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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:��°� �5 Permit Number: JS d'1 - d 4 N RECEIVED JUL 2 91015 • 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: To Select from dropbox, click arrow at the end of line SI 910 PROPOSED 1MPRO.UEME:NT_LOCATION r i Address: G®LF : LJIG Qa�,t�cy4 4cz—r � Legal Description: 6.v- G 0, Q i,t ci LL. IMF S�law�S �s dQ d 11 - 1 S 2Z Property Tax ID ©Z' 00 OO COO — g Lot No. Site Plan Name: (;cLJ O LL L AS �� �i fS���L Block No. Project Name: 4 0"k S'f C2 .SLS til )4r, I X LAI/ Setbacks Front Back: ';;70-F Right Side: [3 i- Left Side: ` o`l- DETAILED DESCRIPTION OF WORK qle�oLze 4 i TAS t W Wto C_ L, '. SL_kA$ . CONSTRUCTION INFORMATION ti >.. Additional work to be perlormecl unclert is permit-c ec a appy: HVAC Gas Tank Gas Piping Shutters Q Windows/Doors Electric 0 Plumbing []Sprinklers Generator Roof Total Sq. Ft of Constru on: S . Ft.of First Floor: Cost of Construction: 1,,-- 22s Utilities: Sewer Septic Building Height: OWNER/LESSEE - CONTRACTOR ; Name60lF PwAs Name:-lMy-CxiS - y Address:.772. 'S i. Company:A,C-,G •t-NOl• �O,�S��1C l;.01! lam. City: �ySIC�„�l State: Address: 'M. 9y9c -Z AW. t1J Zip Code:M5 73 Fax: City: Gw,/<C- O oyL,.� Stater Phone No. J' 10-1114 Ll” 646Zip Code: 3'306.7 Fax: E-Mail: oK6 .ccs Phone No. Fill in fee simple Title Holder on next page(if different E-Mail:Ifl�azt�ottut �}C�uLi C��S��G►�iJ from the Owner listed above) State or County License: GV0v? CO- If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. a`�yaa� SUP'PLEM.ENTAL CONSTRUCTION LIEN LAW INFORMATION} - � Y 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 improvem nts to your pro ert .A Notice of Commencement must recorded and posted on the jobsite before t first inspe n. If yo ' tend to obtain financing,consul ith le or an ttorney before com e n cordin ur Notice of CommencemIMt. s Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA, , •�� STATE OF FLORIDA COUNTY OF ( . �y�c- COUNTY OF ✓( C71� The forgoing instrument was acknowledged before me The forgoing instrum.!pt was acknowledged before me this 27 day of TULY . 20 l.�y this ZQ day of s 1[X-`l ,20 by (Name of person acknowledging) (Name of person acknowle ing) (Signature of Nota ic- ate of F da) (Signature of tary Public-State of FI Personally Known R P d`�r�IldgRJ}Tcation Person Known roduced Iden`��( fjpn,�_ Type of Identificati Prod -_ �P� FV �//4 Type Identifica ' roduced�/ ` ���� ��i Commission No. Q `0`'QSgal)' �y Commission No. l�__8.39.99 r" dam` y f�'2016•• . , v a nj m• � ti e � m: � Revised 07/15/2014 ••.Boyd Are:• �`` '•.ao� � ,5��'•�� . sd li;[os, �P .� � .ded Ihro�4;•• '� � ' REVIEWS FRONT ZONINW'"�`[`OSUPERVISOR PLANS VEGETATION SEA TURTLECANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS