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HomeMy WebLinkAboutBuilding Permit Application ALL AP=FO MU B PLETED FOR APPLICATION TO BE ACCEPTED Date: ` Permit Number: L J C I 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 Sop ox, c Ic arrow a P - mmAt t FC*� EI CATIO IN . K .. Address: _ r 3 Legal Description: P o LCA t 6 II b 6 M lblp ®✓Q Poghle � Property Tax ID#: C25� CC)OD— do Q Q� Lot No. Site Plan Name: Block No.. Project Name: Setbacks Front Back: Right Side: Left Side: 1VOW r L /�,j :::xYaJM'`�•"i'6•,.. ���°[�/('(`��j�{� - ] ��»�' - yam' � �- �, y t�y�.'�`az -0 ?t�s�"�iaz •2. - r _ '3w, (ti�' •s a�yrORMATI � # rf. r5u4x �ai .¢` '� >' 's} vAd 35 e ;��, Additional work toe nerrormed under this permit—check all that appy: ❑HV C 0 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors g O'E'I'ectric Plumbin Sprinklers Generator Roof — — — Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ F0© � '® Utilities:cn Sewer❑Septic Building Height: z's sF�: .a : �.:�`,.< ,rim ,x�s.• �.�..,t. ���>�:�. ,aa'�tr�a xz�,�2 7. _: ..; x���a�ti=,a��'. Name_ �'�___(�,z'�I 0_ lame. iq 0 � �c eY�r C h�lfiV Grt� Address 9-2-85' ►V4 2 r. Company:I �� t�2C L cl�� f City: ��� State: Address: PS-6 40ttvux- Zip Code, 347 6 ax: City: A W2"k State: ��- Phone No._ _ - Zip Code: :kld ( Fax: 3 QS CWn?2-- E-Mail: Phone No. ;C ff� Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: ® Not Applicable MORTGAGE COMPANY• Not Applicable Name: Name: Address: Address: City: State: City: State Zip: Phone Zip: Phone FEE SIMPLE TITLEHOLDER: 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 is 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 res - our paying twice for improvements to your property.A Notice of Commencement must be,reco� and p ted- on the jobsite - before the first inspection.'If you intend to obtain financing,constxlf'ith lender or an a orney before commencing work or recording our Notice.of Commencement: Signature of Owner/Lessee/ gent Signature 61C-cari—Mor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY-OF orc-A. COUNTY OF 6nL�d►'I�' DS C The forgoing instru ent.was acknowledged before me - The.forgging instrume, acknowledged before me this pa of..... c�` 20 ey this day of 2l)f by vov�i A 0146 r I o �( 0 N c) C N (Name of person acknow dgi+ ' �- ame of pers cknowledging) W FRANCIA BELTRAN r z Notary Public-State of Floridw y W cQc My Comm.Expires Dec 1,201 cc % of KO Commission#EE 150144 (Signature of Notary Public Signature o d Public-State o a) o a E 'E JE / i o Personally Known . OR Produced Identification. 'DC Persona Kn wn v OR Produced.ldentificai Type of IderLtification' Type of Iden fication 't rJ'r 1 Produced_ L LAX W �n ccu.� Produc kA Commission No. ia, l l (Seal) Commission No. REVIEWS FRONT ZONING SUPERVISOR_ PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW _ REVIEW DATE RECEIVED- DATE COMPLETED ev.