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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLf INVO MU BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RE 11 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 COM ercial Residential PERMIT APPLICATION FOR: V)l, 1 dress:7962_ SbO%� III FYT1 p►_r_& Legal Description: Property Tax ID#: 1;Q � 62V%Lf U3 -006-3 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: J Right Side::.--/& 7Left Side: RN EEIMLIfinoWMORCRSIP 1i® ,F�llORi . g. ow"M e- 1\n � �\e�� ova to :� 1)� C{3 TRaEJCTt1 l N_fQRa 1,N: Additionalwork to be pertormed under this permit-check all that apply: _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: $ i U?5 ad Utilities: —Sewer -Septic. ,s.,Building Height: TR R; mi 76. NameMortcf .T J4czrbdn Name Address © so 13 ib Yl C,A City: )6-,4T/ e- rCe State:KZ, Address: Zip Coder 9 7 SI Fax: City: State: Phone No.712 8q0 I -70 p2G1_960 i-M Zip Code: Fax: E-Mail: T Phone No Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or unty License If value of construction is 2500 or more,a RECORDED Notice of Cow--n ement is required I rn_2 --R 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 Horne 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. W—NQrj't � 110r TCA 010 Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA / STATE OF FLORIDA COUNTY OF _ L, Ic COUNTY OF The fo ping instrum t was acknowledI d b fore me The forgoing instrument was acknowledged before me this day of 20 this this day of ,20_ by )A :6 (Name of person acknowled ing) (Name of person acknowledging) (Signature of Nota i -State of Florida ) (Signature of Notary.Public-State of Florida) „P A Y •1PRV Personally Knower°. : P�j��ucl$®riili�gion.. Personally Known OR Produced Identification Type of Identifica o ;. ry PuDITc,State o1 on Type of Identification Produced mission 0 to 234730 Produced ,, gondedthrau Ir May 27,2019 Commission No. 9h n INotaryAssn. Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/203.4