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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED , / Date: �' Permit Number. 1�o� " 001 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: ' ROP©►S�- � INPRt+) YE ' NT I.O•PATI'Q'N. Address: 6 no g C 14 Y, Legal Description: PropertV Tax ID#: 3"/C) ll "600 Lot No. Site Ptan Na . Block No. +me: Project Name: Setbacks Front____:_ Back: Right Side: Left Side: .. DETAI�.ED Df�SGRfPT ON OF W�R�K: oldA ! Swtake b��. LJtfr� � L 0t/1 oYt i ower Por �YW ( S Wry CONSTR CTfiON INFORMTjTA N. rtiona wor to a pe Orme un ert is permill. ec a t at app y: ill Mechanical Gas Tank Gas Piping _,_Shutters _.__Windows/Doors /Electric __Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ Utilities: _Sewer r Septic Building Height: OWNER�LE�S'-SEE: ill All 111 CONTRACTOR: Name J�1�N , Name:— Address: r PiM� L3 ���� Company:_„_ - S/ h h S �oc.� State: Address:- City, City: - �,I�,,,�Ll State: — Zip Code 9 5/3S Fax: City: . Phone No. 2 2 Zip Code: 3 q Z- Fax: Phone Now E-mail, (if different --- Fitt in•fee simple Titte Holder on next page E-Mail,.,State or County License — from the Owner listed above) _ - if value of construction is 2500 or mare,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: `Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLEHOLDER: _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 thepermit 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. /Ma.rS�y � _Signature of Owner/Le see/A Signature of Contra or icense Holder STATE OF FLORIDA ' STATE OF FLORIDA COUNTY OF COUNTY OF <1, (.L&e;e The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this"/ day of �(/a✓CIS"` Pr . Z0/�by this 1C_day of NQy Lev _20.lam by xA 5Lek^ Vt k.. Mai-Aat(I (Name of pers n cknowledging) (Name of person acknowledging) (Signature of No a Public-State of Florida Aignature of Notary Pu -State of Florida) Personally Known OR Pro ced I f Eation Personally Known � � tification Type of Identification Produced Type of Identification Praduc d-ISL Uv Q WF de �'Ar -C ((N� 1 Commission No. (Seal) Corr `�0. (=P 20 °1 FiorlUaal) '10 1 collifflissiol, pires 9_-26_-M16 Revised 07/15/2014 Commission No. FF 908X6 R � • AN ELA M HUFF REVIE ,Sri. .` Q t ry Pu tIZONI gi Florl aIIEVIEW ERVISOk PLANS VEGETATION SEA TURTLE MANGROVE __•• EkiffeUtIMI. I . F%4730 REVIEW REVIEW REVIEW REVIEW DATE .',IFOF, ,•;7 y omm. xptres May 27,20 9 COMP ""'"� bonded throu h National Notary As n. INITIALS