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HomeMy WebLinkAboutBuilding Permit Application R ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: a 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: I w/door O/µ_ (!Ajt�6C a(L PROPOSED IMPROVEMENT LOCATION: Address: f5-3' 5,( �t✓ L V`��� I� Legal Description: Property Tax ID#: D p0 3— ©QCT " 3 Lot No. Site Plan Name: ZL �i / Block No. Project Name: 40LL // E Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION'°OF WORK:",;' b 00 1Z— l leC— '?6-16- /6 9- ,;ZZ Af0 —* /S-0 5D 5-, /3 CONSTRUCTION INFORMATION: Additional work to be nertormed under this permit—check a appy: L- HVAC Gas Tank Gas Piping _Shutters L�11 ews/Doors Electric 0 Plumbing Sprinklers F]Generator Roof Total Sq. Ft of Constructioln: �l �� S . Ft. of First Floor: Cost of Construction: $ Utilities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 6—_A/j_ Name: -b&-7,J i\J 1S /cJCsL,(�( Address:J / M�Z 1/! C ECompany:A( [,G/ City: Stater Address: US-1 SW �s'U Zip Code:j a— Fax: /� City: t�O� �► AU 1IG�— State: �2— Phone No. -2_2a — q66 1_7 Zip Code:?j5Q6ad ! Fax:�W q�a E-Mail: �z� Phone No. 47qa J�Jv Fill in fee simple Title Holder on next page (if different E-Mail:kn 1 Y16- lh;ff �-0&01.5 , co 11"l— from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIENLAW 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: of 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. r r 41U2 f77 - — a w S _Signature of Owner/Lessee/ gent Signature of-Contractor/License Holder STATE OF FLORIDA STATE OF FLORI A COUNTY OF cnks'016 COUNTY OF t3 a3w40( )� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this kv3 day of k)(L 1Lm�Ct-C 20 LY--by this kc3 day of nQlCcsn�Cur 20 j by fl Ct_ vi N 15D (Name of person ackn_o___edgi )--- ---- (Name of person acknowledging) C ( ' n tary -State of Florida) (Sign ure o o ry f Florida) PRerso I nown OR Pro 'f' ersonally I pwn R-Prodaeed-Ider>ti€ic-aio Type of I entification v qqq I Type of Ide•tification Produced HDI +: +: MY COMMISSION R FF 102359 1p...... Commission No. EXPIRQSdh1)Ch 16,2018 Commission No. ;'=a""' ': �f S 1�YRAMIREZ ;,pd °.'` Bonded Thru Notary Public Undenvrilers ?_ MY(L$ ISSIDN#FF 102369 EXPIRES:March 16,2018 Bonded Thru Nota Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS