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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date. ,�d� 1 �5 Permit Number: RECElV':_D OCT 012015 Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 X Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential \ PERMIT APPLICATION FOR: ,0 PROP®SED IM `R®DEMENT L®CATI(3 Address:X90 A6#/es ld/ve/ Taif%re-� , e_4c-4, a 1 y9,7 7 Legal Description: .41e-#1e,f ];J4j1l./ ynC• )_,``21Y,3 .3 ZZ -II Property Tax ID#: 7 5'0) _5-0I" 12 l/ 7'000 - 7 Lot No. Site Plan Name: 6?f Block No. Project Name: /oso Setbacks Front Back: Right Side: Left Side: D�ETAIiL1�Cf0"R� fern04 ?o 41 rei-20-va 0 f fe ICf Orn Pv�lL/ C©NSTRUCTIOrN INF©R�MATIDN: ditional work tobe erformed under tis permit-check all that appy: HVAC Gas Tank []Gas Piping _Shutters Windows/Doors Electric ❑ Plumbin-gSprinklers -Generator Roof < Total Sq. Ft of Construction: 97 Sq. Ft..of First Floor: 7Q Cost of Construction:$ 700,q'10 Utilities:xsewer Septic Building Height: 87r7l U�U,NQS' E-SSEE: C_ON RJICTOR: Name ar. ?l� 'Ja B@ Z u n!/!/�SS�v1 Name: /� .c4s�r+� Address: %0"13 ✓� 114 R/V Co"mpany:/T r4 5;�; Alae��i City: ,Ten•s"h JRl--% State: F-Z• Address: Zip Code: y J 7 Fax: City: ye/7 % �n!it%' State: /"L_ Phone No. )9d 7/7 ,200 7 Zip Code: 3L/y Jr 7 Fax: 772- ,1 - . E-Mail: Phone No. '77,2 - 9�o O -371T Fill in fee simple Title Holder on next page(if different E-Mail: el,-lu II 5:Pl %h G Odf�i�jo4• CQ�`+ from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SIJj'PF'I�EM;ENI:�AL C®NSTR;IJ' i®N LIEN LAIN/ INFQRMATI®N' IN DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you inten to obtain financing, consult with lender or an attorney before commencing wor recordingA1crTr__Ndtice of Commencement. s _Signature of Owner/Lessee/Agent Signatur o ractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF e,'t, I-ycyk The forgoing instrument was acknowledgbefore me The forgoing instrument was acknowledged before me this\day of G CA , 20%by this day of 20 `5 by (5,&6,$m 5 M,\ -4N CX�k 6-^ ,n^ -h (Name of person acknowledging) (Name of person acknowledging) a^. (Signature of Notary Public tate of Florida) a, '"� (Signature of Notary Pub c-State of Florida) Personally Known OR ProduceV',, ieftiltfici�C6Fw, Personally Known OR Produced Identi Type of Identification Produced_a �e. _ Type of Identification Product�,d L SNA 5 e°, Nota+y ExP';e 8581 ubllc" II ? Commission No. 0 n °��+o ��e�lf �E No�a�y PSs� Commission No. 8 Nota+y Pl zs fie° a 6ti ` . , �ou9hNaUona� - nded •o= �0m hrouch Na�iona _ Revised 07/15/2' REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS - Planning 8 Development Services_ ASBESTOS NOTICE Building&;Cade Regulation Division,; :2300 Virginia Avenue; ForE.lerce,FL 34982' Phone{772 622172 fF :17721462.6443 Asbestos Notice to Contractor October 01, 2015 ADAM SMITH BOBCAT SERVICE INC ADAM SMITH 661 NE SPENCER ST JENSEN BEACH, FL 34957 FILE COPY RE: Building Permit Number 1510-0007 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 10/1/2015 12:33:43 PM