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HomeMy WebLinkAboutBuilding Permit Application All APPLICApB E INFMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 71 Permit Number: SCA RECEIVED AUG 2 6 2015 -- 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 1 PERMIT APPLICATION FOR: PROPOSED tNPR®UEMFENT' LOCATION: Address: 23� Legal Description: Property Tax ID#: 1 �p�2 �� Z(� ry �? Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Dfi'AI�LE® DE:�SCR�I°PT#©N Of 1N®R�K: VkM'W!)L\.g — J W AU ,'AJ e Q e,J 5 .IIX o p-lze� CONSTRUCTION I'NI=©RMATION: Additional work to be pertormed under this permit—check all that appy: _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: $�jOoO•,00 Utilities: —Sewer —Septic Building Height: OWN�ER�LE�S`�SEE: CONTRACTOR: Name S Name: Address: Company: City: )-I• State: f7LAddress: Zip Code: Fax: City: State: Phone No. Zip Code: Fax: E-Mail: SC.O �'sam d's Phone No Fill in fee simple Title Holder on next page(if d' rent 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. S PPI.�M � T; l�ONSI"RUCTION Ll��i 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 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. Signature of Owner/L see/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S�-�Lvc*\ COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this--t,(* day of 20 A5 by this day of 20_ by 4 a•Me\ �''`.� ey-5 (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pub'c-State of Florida ) (Signature of Notary Public-State of Florida ) Personally Known OR Produced Identifca 'o Personally Known OR Produced Identification Type of Identification DEANNA GIVENS Type of Identification Produced L y public-State of Florida Produced �• ._My Comm.Expires Dec 16.2016 Commission No. E } ion#EE 858761 Commission No. (Seal) Cd Assn Bonded Through National Notary ter' REVIEWS FRONT ZONING - SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED T_ ev. Aianning&DevelopmentServices ASBESTOS NOTICE TO OWNERIBUILDER $wilding&_fade Regulation Division, ;.:23.00 Virginia Avenue; Fott,Plerce,F!".34982'., FtOn®{772j462-2172FaW—,2J462-6443 August 26, 2015 FILE Copy PAMELA L MYERS 12321 S Indian River DR Jensen Beach, FL 34957-2253 RE: Building Permit Number 1508-0411 Disclosure Statement: State law requires asbestos abatement to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you as the owner of your property to act as you own asbestos abatement contractor even though you do no have a license. You must supervise the construction yourself. You may move, remove, or dispose of asbestos containing materials on a residential building where you occupy the building and the building is not for sale or lease or the building is a farm outbuilding on your property. If you sell or lease such building within one year after the asbestos abatement is complete the law will presume that you intended to sell or lease the property at the time the work was done which is a violation of this exemption. You may not hire an unlicensed person as your contractor. Your work must be done according to all local state and federal laws and regulations which apply to asbestos abatement projects. It is your responsibility to notify the Department of Environmental Protection of your intention to remove asbestos. It is your responsibility to make sure that the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Owne ignature& Date 8/26/2015 2:31:45 PM