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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 9 —��� Permit Number: RECEIVED Lz �h ECE111ED +, 894 , Building Per it Application Planning and Development Services OCT 2 zo�5 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 INPR01lEMENI" LOCATnION: // Address: �OO ZL4 R 29:m G V Legal Description: Loi' '�- aLoo'k yF Property Tax ID#: j 9 Gy?l — (5-C)o— Lot No. Site Plan Name: Block No. Project Name: �- � Setbacks Front Backer J Right Side: Left Side: DETAILED DE�SCRIPTI©N 4F WQRK: Palin a sibK. c3 /Q O 14(r 99mop p CONSTRU TION INFORMATION: 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: Sq. Ft.of First Floor: Cost of Construction:$ Utilities: —Sewer _Septic Building Height: OWNER/LmgSEE: CONTRACTOR: Name I-A -1es 4� Name: IZO 1!U — o Address: U Company: KIZA d ' �7SSuCity: 0 State:_ Address:!R�y �Jdb&&(PM QQ. Zip Code: 3 Fax: City: &C 1 S`j` ,L.DG1`L Stater> Phone No.. ��-- ��oL Zip Code: S Fax: E-Mail: '~— Phone No Fill in fee simple Title Holder on next page if different E-MailL! R from the Owner listed above) State or County Licensecgo— OQ 17> J 7y if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SU '1000.I T CONSTR CTIO LI'EaN LAW NFOR�MA 10 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 NV�ttW of Commencement may result in your paying twice for improvements to your property. A Notice4- 16in mrfiencement must be recorded and posted on the jo si before the first inspection. If you intend financing, consult with lender or an attorney bef commencing wok record' our Ice'of Commencement. / Signatur Own /Lessee/ ent Signature of trac License H er STA E OF FLORIDA STATE OF FLO%DA COUNTY OF COUNTY OF k L_ Q07- The forgoing instrumen was acknowledge before me The for oing instrument was acknowledged before me this day of 20 by this day of P� 20�5) by 1►..,r !A (Name of persona knowledging) (Name of person cknowledging) (Signature of Notary PublW State of Florida ) (Signature of Notary P ic-State of Florida ) S a � G�v�C1 E�o��a ENS �°clba Personally Known OR Produc ,t� t�sn°� 6 Personally Known ORP _451c�ti 6n 6 Type of Identification Q°n��C".\�esoe° 5a�51 Type of Identi ication pub�`C s5� c I �P E 0 pss° o�a�y Eo\le 95ai Produced L L oda mm.E °#E ��0�acy -Produced P.e<-,, N m. °#�� • ��tiPti �• .',=MSI"°mm\Ss�bNi;.o° J� _ �o 'a ,=My G°mess,,hNa`�O�a��No'°`�j„h.�u. Commission No. [ _ :o_ (r$���.p�°��' Commission No. °odedjbea7J' REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.