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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE EIINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: O 1���� Permit Number: i RECEIVED Building Permit Application Planning and Development Services AUG 14 2015 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: PROP©SED IMPROVEMENT LfOCAT14�U: _ Address: 770-7 N . tfW y A•-!A UNI 0`t- F `r(�Gf1� F[, �q Legal Description: grogAl Coyg5 06�g L- SE�t ` 614G 7 N G7 Property Tax ID#:- zi 7 rfj — Lot No. �o Site Plan Name: Block No.7 Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DEQ CRLPTION OF WORK: l^oy&� S &t,i CONSTRUCTION IN �® +MATlON: Additional,work to be pertormed under this permit-check,all that appy: Mechanical _Gas Tank _Gas Piping Shutters _Windows/boors • .Electric _Plumbing _Sprinklers Generator hoof Total Sq.Tt of:Construction: Sq. Ft.of First Floor: Cost of Construction: $ j TR2�p Utilities: —Sewer —Septic Building Height: OWNER/LESSEE; CONTRACTOR: NamebSf�tra"T �`'kL�1-tet. Name: ( f���C__ _ Address: 210"7 N. gwV -(;�A /ijutt—% Company: G� City: Fr Prcoe r State:f jr Address: Zip Code: Fax: City: �A4iE',T 1e,C State: Phone No. CA 5.1 2r� 915__w Zip Code: ���/ P�- Fax: ���..1/(� /•(�7/�i E-Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License t7�' Gj If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S•tJ'PPLEMENTAI C®NSTRR,IY, N HIEN LAUV INFORII/1AT10; DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: 4-I A,ra1&-j1 [UE�tt fULN Name: Address: -77eL , C-i Address: City: State.�� City: State: Zip:`3SZ Phone 75Z -4c'6 4224 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 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 in,svection. If you intend to obtain financing, consult with rider or an attorney before commencing r rdin our Notice of Commencement. Signature of 0 Sig,ature o der Z-5 n Rj a STATE OF FLOR it'd STATE STATE OF FLORID COUNTY OF ;i2 a COUNTY OF ni-`�i-;--W The for ing instru nt was acknowledged�efore c? The forgoing instr nt was acknowledged befo Z6- this day of 20� by ¢5 LU d this�day of 20)J by = ON- i g m f (Name of person acknowledging) _;...,,.:�°_ (Name of person ackno ledgi g) "rn„ b •1i ` (Signature of of Public- ate of Flori a V (Signature of JWtary Public-State of Floricdfa) Personally Knoww—"– OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW- REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te-v. 7/2014