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HomeMy WebLinkAboutBuilding Permit Application 941-1 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED tl 4 4 Date: Permit Number: s-- RECEI"-D JUL 312015 i 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 1 Address: /Q cu—i ©C I= Legal Description: Property Tax ID#: �J�J�� / op yE_ 000 -3 Lot No.,#"/6 Site Plan Name: _ JJ,, Block No. Project Name: �/Vf(/L� l�7W,9(29 I: i. Setbacks Front Back: Right Side: Left Side: /W a�­l 6J r, 11 Ir i n 411 ArCc:�llI-F C Ti(Y?5 _70 77�� FX/ 7// 70 7?5� �'�vsTi 1551/9rn,p IZ� zve?v_ Additional work to be nertormed under tispermit—check a appy: HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors 2'Electric Plumbing Sprinklers a Generator EIRoof !_ I Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ -3,�ZO 9 ®� Utilities.. Sewer Septic Building Height: Name ZLG /�'1 ETT`l�1417 Name: /l /� Address:2/:�T7_3 ffEff Company: i���C� City: Ol� State: ►off Address-OZd /(014J Zip Code: Fax: City: '-S: Cucr State:yL Phone No. 72Z— /Z Zip Code:,�, Fax: 77Z "VL ' � E-Mail: d£r`T e�rravft Phone No. 77Z--3 YO 7y7�f Fill in fee simple Title Holder on next page(if different E-Mail: I3/--oGW49 from the Owner listed above) State or County License: O is If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 1=: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State, Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: ✓fVot Applicable BONDING COMPANY: t1Not Applicable Name: Name: Address: Address: - City: City: Zip: Phone: Zip: Phone: t= 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 intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. ,/,4"7 S Signature f Owner/Lessee/Agent Signature of'Contractor/License Ho de STATE OF FLORIDA4 STATE OF FLORIDA COUNTY OF <-U ,QJ�. COUNTY OF Sf, The forgo g instrum w acknowled ed b fore me I` The f ng instrum w s acknowledge t7�#ore me g � this l y of 20 aby this - of 20 by .: (Name of person cknowledging) (Name of person ack owledging) _�Z////vI gnature of Notary Public-State of Florida) (Sig a of Notary Public-State o Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification ificat' nd Produced Type of Identifica Ion Produced Type of Ident 1 r i Commission No. ;; '': KORO �GWRNER CommissionNo iter?LF,, ��I ,S--a ' HER MY COMMISSION#EC=11didCf ca .4e iWY COMMISSION#EE11 41 Ar, oio_e EXPIRES October 11,2015 (407398.0153 FloridallotarySarvico,cofyi (407)398.0753 Flcrdallota Revised 07/1512C� "�`� ryService.com REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE I COMPLETE INITIALS is