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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: q- /5- Permit Number: RECEIVED NOV 04 .2015 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: PRUPQSED 111/i�h"R®UEM'ENT LOCATION: Address: /013J5/ Jr Qc.eci,,. Or, 1_ot9?lrTanjen Legal Description: 14/iA6&1,1L1 '/+/G e '7 1 e Sal 4:nJGw o 9,6/M ,/yo Property Tax ID#: Sf//' D"PD7,'—COO'/ Lot No. Site Plan Name: kl,�;idiv`/l Block No. Project Name: 9� Setbacks Front Back: Right Side: Left Side: DET�AiiLED D'E�SCR+1'PTI®fil OI`WO'R+K: ry. l ml,le e elemo Ahvji ea//o r-ei ovcl 7l �/'O f� 7� y►�m6i� /�Gh�f C®NSTRl1' TIQN IN!FORMAi'I®N: Additionalwork toe e orme under t —checkispermit a appy: ❑HVAC E]Gas Tank Gas Piping _Shutters Windows/Doors 1-1 Electric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: y 7 3 S . Ft.of First Floor: y7 Cost of Construction:$ /7©C"Oe Utilities:Sewer Septic Building Height: 1pFf ®�U1/,eNiERIL€�SSEE: C©Nl'R=ACTOR: Namei/y'r#Nw A. d- Pen,1y h? _oolt Name: - r„ �„fiti Address: /,QY51 Jr G6e4,,. A-. Company- .�Vc�yn ,�mj1'� %lc� f fuc- 14c. City: J_eHfB,i /je4ch State: 6 Address: dGl .n�G•• eH�e, t�- Zip Code: 3 y y_:7 Fax:772_-,27 7'0 932 City: J_oorzl+ enc! . State: f--L. Phone No. 77)-' 2de- 6 O 7 Zip Code: 711516-7 Fax: 772-2.32-2-191 E-Mail: '- Phone No. 7 7Z -240 - 37/5 Fill in fee simple Title Holder on next page(if different E-Mail: ra.,4 t"tri1 i h' %4 L 61 `,?/)oc.C QIv1 from the Owner listed above) State or County License: 6166 42-6-19a/ If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Sl1PPLEMENTAL�®NSTRl1C11®NHIEN L,4UV I:NFOR+M�►TION 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: 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 commencing work oprecordingour Notice of Commencement. s _Signature of Owner/Lessee/Agent Signature Contractor/Lice Holder STATE OF COUNTY OF FLORIDA STATE OF 5-1- Lo1-Q COUNTY OF FLORIDA c The forgoing instrument was acknowledge before me The forgoing instrume t was acknowledged before me this�day of•Nab 20 _by this day of CO 20',S by -IN�4.4�1 S,rn;�1� ��a"\ 'S- m. �-"(N (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary PubR-State of Florida) (Signature of Notary Public-State of Florida) . u fJS Personally Known OR Pr&ucedeldn nS Personally Known R-IF ed IdEffit7f&AI\0'�Type of Identification Produced AN��� �r Ftosbaa '' Type of Identification root %s'% blic State publ�c-'C �ec.6I'�d _ r�=�'�«' MY Comm.Expires g56i61 Commission No.EE °t�� pal BP`S#�Eg5B765 , Commission WYE C0t03,5iljn# Assn. ammissto° a,;;c;ar�p55$d" '''%1,;F o.c�°;� Bonded Through National Ncta�y •; A •�' G Revised 07/15/201 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE [INITIALS ;P{arming;BDevetopmenEServices'a - ASBESTOS NOTICE ;Building&Code Regulation Division: 23o0 virgir6Avenue; Fort Pierce;FL 34982' Phone(T72j482 2172;fax(772)462 8493 Asbestos Notice to Contractor November 04, 2015 ADAM SMITH BOBCAT SERVICE INC ADAM SMITH 661 NE SPENCER ST FILE wary JENSEN BEACH, FL 34957 RE: Building Permit Number 1511-0078 It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal law. Signature Date 11/4/2015 2:22:38 PM