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HomeMy WebLinkAboutBuilding Permit Application i•i .'JPLICABLE INFO MUST BE COMPLETED FOR APPLICATIOUTO BE ACCEPTED Date: /c� //, Permit Number: - - RECEIVED DEC 31 2015 Building Permit Application PERrOIT 1NG Planning and Development Services St. Lucie county, FL Building and Code lteguldtion Division 2300 Virginia Avenue,Fort Pierce FL 34.982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial R'esiden'tial PERMITAPPL,ICATION FOR: Yl� Address: /�M / ' %Ol?. — Legal Description: Property Tax ID#:�ya3'.�Df`�Sd,Opd-/ Lot No. Site Plan Name: _ Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Witlgna wor to a pe orme under is perms –check a that appy: _Mechanical ,Gas Tank Gas Piping ShuttersWindows/Doors _Electric _Plumbing Sprinklers —Generator Roof Total Sq.Ft of Construction: Sq.Ft.o First Floor: Cost of Construction:$__S'f © � - Utilities: 5 wer —Septic Building Height. Name R• elwi& Sty / Name: Cur t.cs ' c,XmFri on Address: IV . ., Camp ny: 15-am Ail Sus'feMS )lyc. City: &_i1i A_14�Y. State: Fl— Address: _1(Q 15._ 5 l;_ `l1 i l(r�a .r r�_�r_-_ Zip Code: 4959 Fax:_ Ci T L..tte i� State: L. — Phone No. /_S_d�'�1��' . Zip Code: , �_S� --- --- --- Fax: X35 1 E-Mail: +S�i E'.c' PhonelNo_ -- Fill in fee siml a Title Holder on next page(if different E-MaiIl,_ 'dQ from the Owner listed above) State or County License: CA C o i,q IO - 5�ate If value of construction is2AWor more,a RECORDED Notice of Commencement is required. 7�cio t DESIGNER ENGINEER: _Nut 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: OWNER/CONTRACTOR AFFIDViT:Application is hereby made to obtain a permit to do the work and installation as indicated. 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 pplicable Home Owners Association rules,bylaws or and covenants that may,restrict or prohibit such structure.Please consult wt,your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit,l 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 recorftg your Notice of Commencement. Signature of Owner/Agent/lessee Signature of contractor icense Halder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF �`. GZ� COUNTY Of ,t°.:T &a-t e Thefor oing lnstrume was acknowledged before me The forgoing Instrument was acknowledged before me this 71 day of ,Lc'/ 20_(.%J by this 9i day of Jq_&r, ,20LY, by L'4J7ID' S ' L-�,r/ t (Name of person acknowledging) (Name of person acknowledging) zx­ - - (Signature of Notary Pu o-Stat f Florida) (Signature of Notary Public-State o lorida Personally ) all Known OR Produced Identification Personally Known Y OR Produced identification_ w Type of identification Produced Type of Identification Produced 11�� gg y,.•-•, CHRIONE 0.ENQL SH �r,��gr P� Commission No. t✓OJ �Y� ,� MYCOMMISSION PEE B946mmission No. �a�dip�:"`:` (SeMTiNeB. gN EXPIRES;April 4,20 7 * iityCOMMISSION IrE859204 �'� ,e q�'4 9andecrThm6uCpelNolyryS la", a E&ApriJ4,2017 riI F4� 4F FLO, collaed I I ru 10991 Norley swam REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTIE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.