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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:��\°� 15 Permit Number: ■■ ,f�t-j - RECEIVED OCT 192015 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: III'MI 3, INP IN LOCATION: Address: 42.'3 , lav%I -�cu�e -�>✓LI� prE-rLC -3���9 Legal Description: Qlz€ I (VO (3 A 7) 6f LQf (4 60P- 1.44 r --gS�) Property Tax ID#: 143U ao66) Lot No. Site Plan Name: Block No. Project Name: Setbacks Front ;Back: Right Side:. Left Side: DEVILED DE�SC' I'PTION aF WORK: --rn e .a.(::' 0&0-t�7 Ce veeU'JC,-fav t e c,S /juD car SC A-c.L a�� U1/�4'nC�ll✓"`yD �c c�,4,v�x'� (20�L -u� �!(EfflINFORMA ION: itiona wor to a pe orme unclerthIS permit-check all that"app Mechanical _Gas Tank _Gas Piping `Shutters _Windows/Doors Electric`s _Plumbing _Sprinklers Generator Roof Total;Sq. Ft of Construction: 2kx0 Sq. Ft. of First Floor: Cost of Construction:$ 97av-`°'' Utilities: —Sewer —Septic Building Height: S� O,WNCR/LESSEE: C®NTR CT©R: Name MALL Cd w L-Al AJ ee&,4h► Name: C // B NL�u A-a Address: ,203 OLb P6m'D LL; Company: %/-r..1 City: StateC O Address: 3111 6L6 4N0EYL ,ANIC Zip Code: �?[(10 S-4 Fax: City: t i ReOCC State: Phone No. q-719 qq� Un Zip Code: _�4ag2, Fax:77Z-rf61 E-Mail: Phone No Z7'y 2l.(o- SQ-4__) Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License IOaB'g/ CX,(_6`$"9'73 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUP'PLEMENTA,t C�NSTRUCTI�N LIEN LAW lNFORMAT QN: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable N a m e: [n!G Name: Address: -7U5- t5t_4E Gtw Address: City V State: /L City: State: Zip: Phone 172 LJW ssD°j 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 tD 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 theper it holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and co enants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed fora y 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 concurrenc -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 i ection. If you intend to obtain financing, consult with I n er or an attorney before commencing ecordin our Notice of Commencement. Si nature of Ow er Lessee ent ''" "°` g g �;�,,.• Sign re of Contract cen r STATE OF FLORI '=�* STATE OF FLORI4.1 COUNTY OF VZ COUNTY OF �� '�_ a5Cjc *t ° The for oing instrKnent was acknowledged bed'a -M The forg ing instr nt was acknowledged before this day of 20 b m this day of 20 ,:by n rn 2 2 Z �e E fvA - ��D � o z (Name of person acknowledging) `°N (Name of person ackn wledging) �T a N � P (Signature of I Yotary Public-State of Flo Ida Mignature of tary ublic-State of Flo ida) Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED le—v.7/2014