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HomeMy WebLinkAboutBuilding Plans All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u Date: zoo— S Permit Number: RECEII" D SEP 2 9 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 PERMIT APPLICATION FOR: PROP.©SED I'NPRC?U-E�MENT LOCATIQ Address: 1 D I oG�rr1 t' �', C . Legal Description: Property Tax ID#: \ Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DENS—KIPTION 0'F WORK: ,T C®NSTR+IJCTIION 1'N IF MIN Additional work to be performed 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: Ig 0 Sq. Ft.of First Floor: Cost of Construction: $ L+ U Utilities: —Sewer _Septic Building Height: ®INNER/,SLE-�S;SEE: 1 , C�ONTR�ACTQR: � _ Name Cr-'.v Name: & r 4., M Address: l t> 1 en,IV\1 Company: Pm4 r t tJar v A ;t! nn b W\FS City: �, S L State: 1.. Address: W;4 N� �fO�Y �4 Y K Zip Code: � 49(K'3 Fax: City: S. I_ State:�� - Phone No. ^7'7 2^ �. 2 ^ �2-�-5 Zip Code: Fax: E-Mail: Phone No — b 2-b^ ZD S' Fill in fee simple Title Holder on next page (if different E-Mail G W r --2- K-1 T. 16J 1' from the Owner listed above) State or County License L ( SO QQ If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. J SSNNEMENa CONSI'R`NI'®N UEN LAIN IN `ORMA ISN: 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. 4Z_e��� Z_2t�� I Sign of Owner/L see/Agent Signa a of Contracto STATE OF FLORIDA STATE OF FLORIDA , COUNTY OF S� , L v e�� COUNTY OF SAM The forgoing instru, ent was acknowledged before me The for oing instrument was acknowledged before me this a day of �'�' 20k by this"QA day of 20_L5_ by Mei eC Cseocd.� 'Me`t � {_ (Name of persbb acknowledge g) (Name of pers n acknowledging' ) (Signature of Notary P blic-State of Florida) (Signature of Notary Pub ic-State of Florida ) Personally Known OR Produced I G�'q*vb(\aa Personally Known OR Produce tOIR0 oda Type of Identification �PNNP2, Type of Identification of b\\o.S�a�eeo�6 Produced 1,.. L t0 Jb� 50�g5�\6 PSSo. Produced PUB[.C,� �omu.ExP�1 #EE 85o �,�NO Commission No. E ,��b � co ' Napo P.- ''" Commission No. z; ; oPa �•.; sT o,,• e °;�` b O. t "qrEol REVIEWS FRO """"� NING SUPERVISOR PLANS VEGETATI SEA TURTLE . MANGROVE COUNT REVIEW' REVIEW REVIEW REVIEW, REVIEW REVIEW DATE RECEIVED DATE COMPLETED ke—v.7/2014 PlanningBDe�elopmenEServices; ASBESTOS NOTICE ;ButldPng&Code,Re�gulatlon,Diviston 2300 VPrginW..Avenua Fort Pierce;FL.34982 ,. Phone(7721462 2172 Fax(77262-6443 Asbestos Notice to Contractor September 28, 2015 AMERICAN DESIGNER HOMES LLC GEORGE A MEYER 379 NW LA PLAYA ST PORT ST LUCIE, FL 34983 ®� 040 RE: Building Permit Number 1509-0440 It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal law. Signature Date 9/28/2015 10:09:55 AM