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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO /MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �/ / Permit Number: 4_7- l RECEIVED NOY 172015 _ 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: Tow�at tete-eed-E�#tine PRQPOSRI 1'M1-1 ME T L©CATION: In 1 Address: Oce. ,-7 J#LS0 Dente, /9,�c4 �L- -3,'175-7 Legal Description: 14//, r,/// L1214 e 7',Ie ` Sof G e16). /70./ 6,w,%-IJ0 er 3W 7F Property Tax ID#: y5-11-,?I0- 00Y7-000 - d Lot No. .70 Site Plan Name: 1i✓/),7/. Block No. Project Name: 1®1 ,30 Setbacks Front Back: Right Side: Left Side: D.ET tL�ED (5E iCR�iPI"ION ": r v ORlvu 77 AIS Po off,'/ Ao,bi e C®.NSTR�L1CTl.®N I'N'FO,RMATI,®'N: rtiona wor to e e Orme un er t is permit—check all that appy:1:1 Y HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors Electric um ng Sprinklers Generator Roof Total Sq. Ft of Construction: ;2 7 Sq. Ft.of First Floor: 17 Cost of Construction:$ /Goo,c o Utilities: L J Sewer 11 Septic Building Height: ODUNER/LESSEE _..: .. C®'NITR1ACTO:R . Name Name: Address: 233 6he,6ucf0 V1•• Company: City: 64`t,,,Ile State: QA/ Address: 1, d/ Wil: Zip Code: L dj ,r)pil Fax: City: JeAf ro I?e,-ie Stater. Phone No. <75Y 1110 3763 Zip Code: IV57577 Fax: 772 Z32 2171 E-Mail: Phone No. 77 371T Fill in fee simple Title Holder on next page(if different E-Mail: arf�vr� from the Owner listed above) State or County License: GSC If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTA11 L CONSTRUCTI©N LIEN LAW IINF©RMATIMRS, „ 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 or recording our Notice of Commencement. _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S-�. L V t 1 COUNTY OF The forgoing instrumen was acknowledged before me The forgoing instrument was acknowledged before me this�day of IO\ 20 NS by this 1A day of i►JC7J 20 AS by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Publi -State of Florid (Signature of Notary ublic-State of Florid .. J IVENS 1 Personally Known QJd�P �r�lifil a �# Personally Known .,.� '�'-1OR Pcb✓ 8 �L#gnt�f,2s �� V Type of Identifi_ w�Produced Type of Idehtificat!pp,,,P,rod�f�`p�Jy A b( . `Vu y Pu( Nola mm.ExP� #EE g58 pssa is ° ` ' omm• 0 EE 858 Commission A i. •,.'4M� mssion�S� )yo cy _ Commission, o, P ` missihNa11 �ry Assn. t.1 ' .' r:. djhcoh9' ti'` '• Sc ohded(h(ou9 yu 9 Revised 071NY-014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS 77 Piannn9.8Devel9pmentServices '. ASBESTOS NOTICE ;Building&{Code Regulation Divisloi►.; •2300,Wiinia'Avenue; Forf_Pierce,FL 34982' Phone(772j462 2172 Fix`(772)462-6443 Asbestos Notice to Contractor November 17, 2015 ADAM SMITH BOBCAT SERVICE INC ADAM SMITH 661 NE SPENCER ST JENSEN BEACH, FL 34957 FILE Copy RE: Building Permit Number 1511-0277 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 11/17/2015 9:49:05 AM