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HomeMy WebLinkAboutBuilding Permit Application Dec 21 1501:47p P. 1 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �� Date: a �,`1 Permit N F k"WRNJ © DEC 1 1 2015 Building Permit Application PERMITTING Planning ond Development Services St. Lucie County, FL Building and Code Regulation Dlvislan 2300 Wrginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lined [� PROPOSED IMPROVEMENT LOCATION: . e Address: Z-00 S Q,--P A-14- Qr Legal Description: I t/ &W,-, S,[l� (fin c�" Y10 A#ld &-rtzA :EhA rc. t r\ C o nn,rVl n 6 V 1W Wf1 it n it �8T -/23 g Property Tax ID 00 3 S—000 - Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF'WORK: 4),91za, �-�fcr uK4u/- Afc, - CONSTRUCTION`INFORMATION: Additional wor toe-aeriormed under tis permit-check all appy: HVAC sTank OGasPiping _Shutters Windows/Doors Electric Plumbing OSprinklers Generator Roof Total Sq.Ft of Construction: Sq. ft.of First Floor: Cost of Construction:$ J�SQ Utilities: IlSewerElSeptic Building Height: OWNERAESSEE: CONTRACTOR: - NameAY4- jk-a at e- Name: sepiiin VQSl Address: d&sr /2 - & -il tD company: G�:%r,VkkmtjLN fUK-L.S City: �Yur tia. State:_N(. Address: Ra SE "fat+dr, Prue, Zip Code: 3�g5`1 Fax: City: ?brt i r, Luctt State: YL Phone No.77A- aal- DSS Zip Code: S4g157- Fax:_7V,-.33S-),00 E-Mail: Phone No. 172-397"3(6`dZ. Fill in fee simple Title Holder on next page(if different E-Mail: �ertesis i��t3 �eN� m Qrn from the Owner listed above) State or County License: d il q if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. p.2 Dec 21 15 01:47p SUPPLEMENTAL CONSTRUCTION LIEN LAWINFORMATION: DESIGNERJENGWEER: 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: 1 certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie Countv 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, accessary 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. s gnature of Owner/lessee nature of Contracto—r(ticense HdEW— STATE OF FLORIDA, STATE OF FLORIDA COUNTY OF - 'f. L COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me g � g g this day of Jkj,�b-t,�_ , 20 lSby this a tt day ofoggill20t"E by ,51 TAW (Name son ck gi (Name er.,n acT , Ing Sig Ft jrrt a of Mda) ' ary a,a; } .1 1NlOO=lr C Personally Known Produced Identification Personally KnownS OR Produced Identification Typ 'Produced ype lion Produced Commission No. (Seal} Commission No. (Seal) Revised 0711512014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLE'T'E INITIALS l i