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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: rte:�:3i.}'�;slh c=�t.,,,sL•: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 Select from dropbox, click arrow at the end of line - tiCfa�i '.S�i•c ,1.' c�{` d�'J,''Y/.Y��� ;:rd',rr3. ^r•4)i r{ .,.r".•,.•'n.:•.::�.... .S K1�=.t' :� r R m+ `P�R:OP:OSEDrF �P O tow!"d .t.�r Address: USD?) Q\f M(_1(T' n1I .2 3'0('-A-QXZeJ.:Ot... .: Legal.Description: Wnrte C I ` IJ 2-N O F S LAq5 P" 2 o k- E 12Z. 2 P} 222 L) 34 S oR - 22 Property Tax lD#: Lot No. 2 2 2 Site Plan Name: ` Block No. Project Name: LP�6 ©1'C'aLdf)c Setbacks Front Back: Right Side: Left Side: .. ... ..,..., .. ... �. ... •�::�. � .y�,..,... trr•.n'r.'•:}i .:4a; r;�: •.S. 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Additional work to -e ertormed under this permit-check all that appy: E]HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors ❑Electric ❑Plumbing ❑Sprinklers ❑Generator _Roof Total Sq. Ft of Construction: 31 Z Sq. Ft. of First Floor: 15 10 Cost of Construction:$-1-a0 •CO Utilities: _Sewer❑Septic Building Height: c'l .,s. ,5'at,,. ,..(..''s. is .;,. ..ar! —�. ..p.9":;�,,. .v.•„y..[eg,i •.Teci!fyra`i..t.:c..t l::•:;1.'".;:•:: Y:T:r V .ry..n,�; 4 ,� R!•;:LES:$•::'�; . � .,,. ,:� ,\, :� �,� �.: •C, x RA. TO -.� .,n. :r?�.,,.:,•.,; �;;;:::: [ y,,S.. :, ..�. ,%N' .,,lI\..,3.:r. �•n[^S}. '.\:1.. A� _. ..4 I•'��� .�} ..r r.L'rYw.In ..f•, A.,... `s1%.:;i.:r3 axr. :y: ':,F. •:1:'•�'+I�a :�FEr,:�:: -e.h�::L�.,.M1',r>a Jr'' .;,7f,v�,j, ,l c�. .7.`• •:6: �Y.. .._ir'9!. ,:�':�:a.• � ��' ,� ,.i: e3.c n ,.•n.Au._•c5*^ 4@ e:+.l ..yh: 77. �:c!'•se`r_.,.te �_. is ':.d>" �`;•Sf•r,! .r.: Name l Name: S Address: n f n Company: City: i01(-F,�1PJCc��JC� State:Vat, Address: 3Q21 S U S �{l Zip Code:_ Q tt 2 Fax:_ City: 4.,(Z1 Stater Phone No. Flo I " 5 Z(-1 Zip Code: 2Q GY 2 Fax._PZ,9U (0900 E-Mail: Phone No. `1-12 Lfkvq LOL000 Fill in fee simple Title Holder on next page(if different E-Mail: S Affini 4J&a J1 tf L&,�_ from the Owner listed above) State or County License:_(�(`(� X32011 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. ON RP 4, L MENTA"t C DESIGN ER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Not Name: f-(, Name: Addre Address: City: V-t-m 0 a V1 in L-5f State: PC- City: State: Zip: 3M((�Cj -Phone: —6-6,0 -A &1-1 o 38; Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not App licable 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 comraencing work or recording-yoW Notice of Commencement. Signature of Owner/Agent/Lessee S*Kature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORI COUNTY OF C. 9 COUNTY OF 81 W,1219 The foQroing instr ent was acknowledged before me The for Ing instr�ment was acknowledged before me this_day of 20_L45 by this May of_aLjOE 20�by acocs V-A 611'0eAS (Name of person acknowledging) (Name of person acknowledging (Signa re of otaJ Public- e-o'f,FWida) (Signa re of t4'P`uI1c- tat of orid Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Prod Type en i ication Produced .......... SONIA66ISSION#FF1254DESTAFNE), Commission No. Mommission No. 0 820 EXPIRES May 21.201 67;3-L8-10 15 3 a407) FloridallotaryService-com DESTAFNEY ill.� SONIA EXPIRES May 21, 20111 mY COMMISSION#FF12542- (4ut)UW-0153 Floridallotaryservice.com Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS