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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /� J �� Permit Number: RECEIV 7D DEC 0 3 201 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 S♦ PERMIT APPLICATION FOR: PRO`PO,�SE 0IMPRO�/EMiENl` L©CATI®N: Address: 102 .f. OGewrC r. a+ ��? � r/ JY91 -•7 Legal Description: G'H h -e 04, A�r �✓��/�`ci.� �,'v+�'�^ �i+�.. �Of d�ji� �t3'f/�'> �> Property Tax ID#: i1_5_11- SS0- (20//— 0120— 7 Lot No. 6 1�2 Site Plan Name: ye)i, �C' Block No. Project Name: X/0 Setbacks Front Back: Right Side: Left Side: 41 AY CQNSTR�tJCTIO,N IN'F(7RMA�1'I'®N°: � - Additional work to be nertormed under tispermit-check all appy: HVAC Gas Tank 1:1Gas Piping _Shutters Q Windows/Doors Electric ❑_Plumbing []Sprinklers Generator Roof Total Sq. Ft of Construction: /I% Z/ Sq. Ft. of First Floor: ��7 Cost of Construction:$ ZV OCZ, Utilities:mSewer F—]Septic Building Height: . ..;.€.3 ",..., wW. )0_9URIX ESSE ° xa Name_l4)z4 A e/' N a me: Address: 101 i� E %d.^4 /,31,vc% Company: In 1'� 'k f . i City: 420,e0 f?Y' je-4 c/7 State: /�L. Address: Zip Code. 3 V J-7 Fax: City: fc?n fe'.- %}G4cl State: FL Phone No. Zip Code: 3Y Fax:_ 7;*-y32 S'/ E-Mail: Phone No. 77,E -;e(s `3 71.E Fill in fee simple Title Holder on next page(if different E-Mail: etW. ,-+ from the Owner listed above) State or County License: C�C/ S/S'J/ If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SCIPPLEMENTAL C©NSTRLICTION LI'E'N LAIN INFORMATION:. 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_r;ecording youjXotice of Commencement. s _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5A-- 1.. UC �� COUNTY OF The forgoing instr ment was acknowledged efore me The forgoing instrument was acknowledged before me this day of @ L 20 by this 3 day of 20 \5 by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary P lic-State of Flo ' NP �a�e° ,6 2� (Signature of Nota Public-State of Florida) PG`vEN E\0��da pE J�\\c.SesOec8��161 ssa EPN c Sake.c�,6 2p1 Personally Known OAR:'r duce idlgntFfi�'�t ptt`c VIA ersonally Known OR 13,111 `i=ed Ident��f�eaf r� spa 16� Type of Identification r• �C�f�u© .,L s�°° �o°a rte' Type of Identification Prod O P ": 1Z°� Commission No. � •$ r` Commission No.r_t:. *o 0\3" W0 o�c 0 - -� a �F`" ' off• e0 V� •.i t 4 ',lA i 1 O�\•\`• 111\\\\•� Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS #?tanning'8oevlopmentservices.rv`t ASBESTOS NOTICE Building&;Code Regulation))tvisiai 2360' irgirit AVe6 Phae{7721462 21T2,F,az,(772)462-6443 Asbestos Notice to Contractor December 03, 2015 ADAM SMITH BOBCAT SERVICE INC ADAM SMITH 661 NE SPENCER ST FILE Copy JENSEN BEACH, FL 34957 RE: Building Permit Number 1512-0072 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. t Signature Date 12/3/2015 2:08:42 PM