Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 �- ��1 J� Permit Number: RECEIVED . . _ - Building Permit Application NOV - 4 2015 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: PROPOSED IIN'PROME K 34,14MIrLOCA',TI/®N: Address: S G✓z ,p Legal Description: o2 lL' 1 /t�S d✓' 4-11e,C�,'✓� Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�SC` IPTI©' OF W®RK: t t' A*,l s&&/ C L Sz V �0 1 Dw � C o'r/Ld�0, a A, CO'EUS-Jffi TION I'NFORMA ION: Additional work,to eperformed under this permit—check all tat"appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors �[ / Electric _Plumbing _Sprinklers _Generator )"Roof Total Sq. Ft of Construction: /A 4d +#6 Sq. Ft.of First Floor: Cost of Construction:$ t 3 idlob Utilities: —Sewer _Septic Building Height: 4 UVNER/LEWSSEE: CONTRACTOR: Name e/`e2 , 4t Pez. Name: o er !y1/W Address:/� IDIt� �l� �1! Company: pS `� �O BJ GtG City: lTy'CL�,(�ftr�! State: 5C Address: /e[ 0//�3 . I CS �.,X/ 4vr .z Zip Code: 2..oZ'i�10 7 Fax: City: C �Z State: �7 Phone No. g28" `/�2-— ! �l o Zip Code:�3 �fI ./ Fax: 772 E-Mail: 'Phone No 227— y6l— '122 2- Fill Fill in fee simple Title Holder on next page if different E-Mail {m/`¢'`j GlwrS �04 C,0� from the Owner listed above) State or County License e/PC&O 5-741 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 1 SU ' P'LEMENT L CONST UCTIQN LIEN LAW I'N§�ORMATIQN; 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 revievy:roomadditions, 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 commencing work or recording our Notice of Commencement. ..Signature of<Owner/Lessee/Agent s^« ' Signature of Contractor/License Holder STATE OF FLORIDA oq�' STATE OF FLORIDA - n. COUNTY OF , COUNTY OF' The forgoing ins ument was acknowledged befor ro o The 7fing instr�um/ent was acknowledged firemeithis day of 20 by a mom" thisday of UV (("(9. 20� � m�e N�9 ��6co� 0 mgt C (Name of person acknowledging) 2° (Name of person acknowledging). �T AL �• a m� N (Signature of 66tary Public-State of FI ricla tl (Signature of taryPub ictate-Sof F rida ) 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 SEAT.U,RTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014