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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1 Date: Permit Number: a :1RECEIVED Building Permit Application DEC 3 0 2015 Planning and Development Services PERrAITTING Building and Code Regulation Division St. Lucie County, `L 2300 Virginia 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 line `PROP }SED IIUIP�ROUElf ME�N LOCATION �` ' £ s t Address: Legal Description:\W%1_'�v►w6 �1.\�6 S 30�'C Ofr 1-(lC1b kndtV KS FT 0� tOZ I'1�0 ��3$U$�`13°I� Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET�A`ILEp DESCRIPTI®N OF W r, RK` gw o Ca,%C fAtL--"V,4v'.0 hC. 1"Su►1 haw w..V% �i*`h t to it\av 'y.e04A4w++0 awl 4iny Sewer f,&1_ �rvvr, BOSS SLE '1n►1�C�Q��.►N� Q.�d'�1�� YCONSsTRrIJsGTIO;NINFORMATION r '$ ifI6 Z. _ r Additional work toe e orme under this permit—check a appy: s HVAC Ei Gas Tank Gas Piping _Shutters Q Windows/Doors 11 Electric © Plumbing Sprinklers 11 Generator E] Roof Total Sq. Ft of Construction: SFt. of First Floor: Cost of Construction:$ ��,dW,5d UtilitiestSewer OSeptic Building Height: Name Sq,.,.v��S�r►vl.��,w,l1,n�gtu0 �t1 -\._�+ Name: Address `��5(, S,W Lv� � _ Company: n City: lko%WA State:!;a Address: 3l h MCW0 lWa. Zip Code 3+G'2.� c: City: RnA �'.Lvz.-t. State: Phone No.•Igb ,KMro 111A Zip Code: 34594 Fax:11Z-$It—900 E-Mail: Phone No. -L _014 Fill in fee simple Title Holder on next page(if different., E-Mail: t from the Owner listed above) State or County License: C�L 4L If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SSU'PPSLEIVIENTAL�C&FN�S�T,RU,CTION LI E�N�L'AW�INFORMfiATtON� `�� � � �,�� ,, , ` , ' ' �, ,1+..�:-a�k,�.s_��_�k:�.�.s �a.=s .'e=e_,,. .•�F�..-.�"_�uw �:?g"t_ Y.... . .»�.,._.�.n. L f..,.€."_ r_,�.. " 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 holderto 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 yy commencing work or recordin our Notice of Commencement. Signature of Owner/Agent/Lessee ignatur Contra r License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTYOF t P I The forgoing instrument was acknowledged before me The forgoing instrum was acknowledged before me this Z* day of 1>C-CFt(3FA 20 10- by this da day of 20 iy ( ame of person acknowledging) (Name of person acknowledging) M, 77nature of N Ly P ' -State of Florida) (Signature tary Public- a of Florida) � Personally Known OR Produced Identification Y Personally Known Type of Identification Produced L TEC-1 —433 Type of Identifica 'on %iffd � � ZLl59l-�j#.NOISSI1�W Commission No. 0/ � 3 rt(Seal, FRANKLIN PEN�Commission No. �s ..� 3Z a 1 S3 Q _ n NOTARY PUBLIC n:+i r RT.�T�lir ca ;�! 3 comm,#EE975703 Revised 07/15/2014 ®R "3 =xpir,,a3/4/2016 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS