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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 16 aaPermit Number: RE.CE11'-0 OCT 22 2015 t !� V . Puilding Permit Application Planning and Development Services I Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMITAPPLICATION FOR: Address: �beeir RV VL 'bvi Ue Legal Description: Q d I � ['a_"Z Property Tax ID#: 14ol .– 0 li —Odb9 r ()Uy d G Lot No. Site Plan Name: nn Block No. Project Name: i Setbacks Front Back: Might Side: Left Side: Now= Additional work to be pertormed un er t is pe mit–c ec a Fatppy: _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: i Name c1.ii rJ�1 Name: e t 2 r i�� Ci.SrO Address: 5 e� (/ / Company: w r rA 2 LL C City: �� _ l �"� e Stajte: Address: 0 '� 19 ©I 3 Zip Code: 3L1 q Fax: City: �' LL 4-t Q State: t— Phone No. Z' �() �� Zip Code: 3 "L4-7 Fax: E-Mail: Phone No. 0 7– Fill in fee simple Title Holder on next page ( if different PUMe bW Holht&"' 311 -7, 3--)63 from the Owner listed above) State or G@+t q License: L C is 0 Ce-,u if value of construction is 2500 or more,a RECORDED!Notice of Commencement is Aecluired. SUPPLEMENTAL CQNSTRucnON'LIEN LAW INFORMATION: DESIGNER ENGINEER: _ _ Not Applicable MORTGAGE COM ANY: Not Applicable Name: Name: Address: --�-��� Address: City: State: City: _ State: Zip: Phone: Zip: r P one: -- ----_ FEE SIMPLE TITLE HOLDER: _ _ Not Applicable BONDING COMPA Y: Not Applicable Name: i Name: Address: I Address: City: City: Zip: Phone: ! Zip: P one: I certify that no work or installation has commencefd prior to the issuance of a permit. St.Lucie County makes no representation that is gry nting a permit will authorize the permi holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and cove ants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for an restrictions which may apply, In consideration of the granting of this requested pl,rmit, i do hereby agree that I will,in all respect perform the work in accordance with the approved pians,the Florida�uilding Codes and St. Lucie County Am ndm t . The following building perm' plications are exen pt from undergoing a full concurrency r vie :r m additions, accessory structures,swi in pools, fen es,walls signs,screen rooms and accessory use t at er non-residential use WARNING TO OW/NR: Y ur fai re t Record a Notice of Commencement may suit' your paying twice for improvements topr per . A N tice df Commencement must be rec r ed a d post n the jobsite before the first intio . I you int nd to"obtain financing, consult with I er o an a orn y before commencin worrec din ou Notic of Commencement. f i f Signature of Own /Agent/Lessee Signature of Contr for/L cense Holder STATE OF FL IDA STATE OF FLO DA COUNTY OF aNGE j COUNTY OFaR �E I The f�j�p in i strume` Rc Howled e arelme The fo 1ng ins u ent acknowiedg d ore me this li'1 day f Ste._, 20 h�, i thisay o —.20 by PETER fA CtAFARB 111 PETER A CAFARU tit (Name of person acknowl f (Name of person acknowl Ing} I ( ignature f Notary Public-State of F orida } i (Si natureo Notary Publi -State f Flor da ) Personally Known x OR Produced identificati)an Personally Known x OR Produced Identification Type of Identification Produced Type of Identification Prod ced EE 174164 mmission No. EE 14164 Commission No. 7NotF Dc State of Flori,Ja { rA4r- Notary PuMiclState of Flofidn Kari M Ricc Boni Kari M Riccaboni { y� T My Ccmmtss+an EE 174 164 } of fro Exptra�q!2 20th I-pi,es 0512812016 �. n✓.� Revised 07/15/2014 REVIEWS FRONT ZONING SUPER IV OS R PLANS VEGETATIO SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS