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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I f Date: l�/-p��- �� Permit Number: ! INl0 - ©45(P elk % 7 ' r ,..--r.,.`ry& '- 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: P,RbP 51ED INPROUEMENT LOCATION` Address: Itoo &N.)3V_T Q Le. �al Description: !�e, 00 k Lo(z / 4 L Property Tax ID#: 23 IS - 112 - ®d aS- „ Lot No. Site Plan Name: Block No. Project Name:ZO-V V..'s Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK E` hx � rt OEM cjL_ OF V_< CONSTRUCTION INFORMATION F Additional work to be pertormed 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:,69" Sq. Ft.of First Floor: Cost of Construction: $ oC , ]lJ Utilities: —Sewer —Septic Building Height: OWNERf LESSEE CONTRACTOR " ' g k# N KPcTr-l�F ti� �u _ Name: r 5 ,.,A . - Name d 1 Address:1l(j,_-) ,Nt'lyy 2-p Company: L City: ,-�i �� 2L� State: (-L Addresses 6U( D Zip Code:3g9g;N . Fax: City: �� �,�cc� State: Phone No. 7) a- 11 (o -362-7 Zip Code: Slk9L 7 FaxQ72-(A62-2'Z0t E-Mail: Phone Nod 7,)-- 24(QG - a2'?U Fill in fee simple Title Holder on next page (if different E-Mail s✓` QC from the Owner listed above) State or County License5-7 9`x"7 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION 0 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 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 commen ,,,in, work or recording yopr Notice of Commenceme '/'/1 415 �""'14ell Sign t re of er/ essee/Agent nature o Contractor/License Holder STATE O FLORIDA STATE OF FLORIDA COLIN OF ' S `Kkl a COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this_&—) day of UC-1 ,2015 by this27 day of QC$ ,20� by (Name of perso knowledging) (Name of persona nowledging) (Signature of Notary Publi -State of Florida) (Sig ature of Notary Public-St of Florida) \ Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced '�CT53�r.tom. .1e3$•� �, Commission No. ftea Commission No. HNptNDRAM LASH AHNAiNGRAM ,,`o4Aa111118`/c public State of Florida y `1111111111,1 �1 Y PV'll� 1 nniR ar Public State Florida Notary ices Dec 2C.2D18j '2. + My Comm.Ex fres 49 =.; •'= mm ssion#FF REVIEWS FbSQR. PLANS VEGETATIO - Tl�° s Nati q E o, d th �Y : '1111 €EVI EV1/ COU12E�H�@�Ahroug ;IE1N "'t REVIEW REVIEW `tV --_sT DATE RECEIVED DATE COMPLETED Te-v—. 7/2014