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HomeMy WebLinkAboutBuilding Permit Application �L ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �'- /� Permit Number: S 6, " 6 1 0 RECEIV7D JUL 31 2015 Building Permit Application �? Planning and Development Services is 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 is Address: 16-75-1 S©L--J`/) 0054? 1?1-/V'E &Q 7- Legal Legal Description: Property Tax ID#: /��l + 311- 00 c16 000 d Lot No. ��/7 Site Plan flame: // Block No. Project Name: ����,QF:= is Setbacks Front Back: Right Side: Left Side: (A C 17 AU / F1 kJ 1%�� PISCO l-92�C7_-t ME7ZT ''socJCc.-%f'or' St,- ✓l cck- 7-H,?- FeL_ 107)2 AOX i MINOR ig��Ili Spin Mailli.11, Additional work to e Dertormed un er t is permit-check all Mat appy: i- EjHVAC _Gas Tank Gas Piping _Shutters aWindows/Doors Electric Plumbing []Sprinklers ElGenerator Roof i- Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 607, ®� Utilities: Sewer Septic Building Height: Name Z•i'� 0/2 T111-1 D L7—P. Name: !F44 G T4 Address:/705- OA1/17Cr- ej Company: Cp�2K1 C® GFC51cA(_ City:0% 10K State:0/i Address: ,�6C� /�l� Zip Code: Fax: City:Par.!.6-r 64/e State: Phone No. 7(o,.57T 2Z?- Z9?- Zip Code: Fax: 772"3 O^7W5 i E-Mail: l�/�`� TGyF�/7 �-L�l %/1'1�IC•,G.�� Phone No. 77-7—HO- 7y_ 7 Fill in fee simple Title Holder on next page(if different E-Mail: i���WiW e_60,eRz0-,6-f3/Y7 from the Owner listed above) State or County License: 1�5_c /3 3 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. h DESIGNER/ENGINEER: -L—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: lSNot 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 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 I: commencing work or recordi4 yQur Notice of Commencement. X s _Signature cf Owner/Lessee/Agent Signaturecof GAniractic License Holde STATE OF FLORI STATE OF FLORID& i COUNTY OF I Lu p L COUNTY OF 6fiC_ Q1 jt The instru as acknowled ed, ore me TheXfobo g instr n as acknowledged b ore me thl dayof 20 y thisy of 20 by (Name of perso cknowledging) (Name of person ack j wledging) gnature of Notary Public-State of Florida) (Si re of Plotary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of identification Produced Type of identificati n Produced Commission No. �� �.® a Commission No i,VPls" w „.:. 1`QVAPKl ER _�o'R---� TOR9 L ER P IY COMMISSION#EE114196 ;p^ MY COMMISSION#EE1 14196 r7XPIRES October 11,1 %",�ecrF,o �' EXPIRES October'V 1,2015 Revised 07/15/ (407)388-0153 Florldallo5?:,::cu.com I; REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE i INITIALS E. 4?