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HomeMy WebLinkAboutBuilding Permit Application All APPLIC FO MLIST BE CO PLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: s 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: PROPOSED 1PR®UE . ENT LfJCATION: Address: 1 a 15- .3-3 (Z� 57-96 T— 9ooPLE P1[ Pt COCE , Fl 3 Y 9 Legal Description: Property Tax ID#: d-`l -7 (4 f V 0d S-000 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D TAILED DRC•RIPTION OF W®RK SC R u i p-c� L S E 12 (Do vdk)I-) LrFo 12 vLt��c��3--�- L 1�(ULT Lo'-" c-'I L CONSTRUCTION IN=Flit li©N: Additional wor to be peffo—rm—ed 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: $ Qt y�`, :.:+ : Utilities: —Sewer _Septic Building Height: OUVNE"R�LE�SSE CONTRAAM— Name J Vtit OT Name. N�,/� fi:� �V Address: 3. n(5 Company: Cab t\'" City: fo )L p �l�� State• Address: Zip Code: -3ygLl'7 Fax: City: State:-E Phone No. "� 7 Zip Code: 9 Fax: E-Mail: Phone No 77 3 91 Y as ? Fill in fee simple Title Holder on next.page(if different E-Mail FO 44,Ul>K &It CTR'(2 !(�?O vL from the Owner listed above) State or County License 5TAC CC°13 C) If valued construction is 2500 or more,a RECORDED Notice of Commencement is required. S P'PLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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. r Si nature Owner/Lessee/Age Si nature f Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA S:�nL �� �COUNTY OF COUNTY OFC`, The forgoing instru �t was a knowledged byre me The forgoing instrument wasacknowledged b re me this o day of 2015by this�day of 20 by (Name of person acknowledging (Name of person acknowledging) (Signature of Nota Public-State of Florida) (Signature of o�a„�;;• - tate of Florida) Personally Kn' Personally K YP ANGELA M HUFF Type of Ide t ' ��ubl Fi Type of Identi p�/•• Produced otary Public-State o1 Florida Produced '+�` �;;;°� muss to of ft0fjda. IFF 234730 orrd P reg 347,?0 , ,F�i`oP�;� My Comm.Expire,��aaff((1127,2019 Commission No. � OUNaI!°n�aY?7 119." Commission •.....,.,,,edthroughNatfOfi�lNdtNY' s,,n _ " A,,,, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ` ev. 712014