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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Ll a 5 1 S Permit Number: 5 J a OCT 14 201 4I I Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Wrginla Avenue,fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential �I PERMIT APPLICATION FOR: To Select from dropbox,click arrow at the end of line Sk� ft Address: (p3o� LI L -4 tJ kw k r� l��2C 3 L{s l Legal Description. 2-1c C-o—, Z FS IL Property Tax ID 1�01 -(n0�1 OD'1 �' O(� — ( Lot No. 2-9 #: Site Plan Name: Block No. 5 Project Name:_ C A- Setbacks Front` Back: Right Side: LeftSide: i lona war o e e- rme u er is perm —c e a ap HVAC E]Gas Tank ❑Gas Piping _Shutters Q Windows/Doors Electric Plumbing Sprinklers 1:1 Generator Roof Total Sq.Ft of Construction: n S .Ft of First Floor: Cost of Construction:$ 40q D t Utilities: Sewer Septic Building Height: Name _Cy tiY��A- C©o IL Name: ,`rk✓h ort - �Q� 1 5�2 Address:(o3Gi LL"AN3 PKw� Company:A4 giurn WL 000 WS 4 I oaP5 City: t=i_ Ai t_4c-�—; State:` Address:Loco .5L,3 Q S+. *- 100 Zip Code: 3 4"(S l Fax: City: DAIJ L I--- State:C--L- Phone No.DDS—Q 4-1— ! (10(0-3 Zip Code: 333 I y- Fax: 'ICi-7 E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: C1> ViC L±aT,oi°� e✓1*• Ca✓'k from the Owner listed above) State or County License: e ZL13a-(a 9 8 S If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I �� ,�..�, h» `"S.'� r x' .ar�a�t ,��.+n ..- Ulu! i � il � .IW z � � 27� x.�p�f�e..Mti@.o..r ��^� C'�-xi-w`;. "dC>? :����`.�i�r v.��.�� '`�i.•-,5 33)oor.�.'���"�.f:�.'_ �r«,`; i DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: I 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: Pho e: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. b 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 G 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 1 will,in-all respects,perform the work in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments. i 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 t commencing work or recording our Notice of Commencement, _Signature of Owner/lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDb a�� STATE OF FLORA COUNTY OF Pao COUNTY OF Q(2o j A-kb Thefor oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 17day of SE-?T6-?T6 -4 . 20)5 by this Z day of Stip E—(S - 20 15 by _T\'vvi oT6 l ko 8 L rJ so r) (Name of person acknowledging) (Name of person acknowl 0- a (Signature of rtary Public-State of Flori )L7_ (Signature of otary Public-State o ' a} Personally Known OR Produced dentification Personally own OR Produced Identification Type of Ids tifi': n Produced ► Type of fdentificationaProduced" JP�e',., CARRIE GERV��KA TAPP �`iY Pia••., CARRIE GERVICKAS 7APP Commissi• E ublic- a f Florida Commissio i tom:_ �t �f Florida Public �" °ar My Comm.Expires Apr 15,2017 �" aaQ My Comm.Expires Apr 15,2017 ,••�ililisP ssion —� rnna Revisec�07�:�1�/2a REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS