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Building Permit Application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1c)- D,3. Ls Permit Number: RECEIVED Building Permit ApplicatQK 2 3 2015 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: (fie YIN�3 PRON-5ED IN!' RO�lEME T L®C TION: Address: 1 % �E �t- Legal Description: Property Tax ID#: I'Z 17 — //1 — 66(3( — 0007 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DE�TAhLED DEaSCRLPTI®N OF WORK: laJ.�f-S4Da� 14 COI<ISTRII ION 1NF®R111JATI®N: Additional work to be performed under this permit—check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: 906 � t""T�inSq. Ft.of First Floor: e� Cost of Construction: $ Utilities: _Sewer _Septic Building Height: n, w Name LL. Name: Address: ° f, pang: aft �Z✓1 City: State:_ Add Q Zip Code: 5 City: ('eq State: Phone No. Zip Code: Fax: 06V 95L3 E-Mail: Phone No FOE Fill in fee simple Title Holder on next page (if different E-Mail `S FGC60 Z G d4A-J • from the Owner listed above) State or County License ZfGf/ If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Sl1$PPLEMEN �1L.CONSTRU 1'!0'N LIEN L�1UV INF®RMATIQN: 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: 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 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)6ou intend to obtain financing, consult with I er7 an attorney before commencing work VTecorAog your DJotice of Commencement. 17 Signature of Owner es ee/Contractor as Agent for Owner Signature o tractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5,C. 1��1e�� COUNTY OF ''k. Lv C:. The forgoing instrurpent was acknowledged before me The for oing instrument was acknowledged before me this�3 day of VO—<- 20�by this day of 20_\5 by CCA'% (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary P lic-State of Florida) (Signature of Notary Pu lic-State of Florida) Personally Known OR Produc �,tVEtAsk t " a rsonally Known " OR Produced Identification Type of Identification pubttc-S A6,� 1T'' e of Identification �. �- - � Produced 1.Q l_- FY'P b��,"" tvotaromm ExPit#EE 85a�6 Psg�. duced L L ,,, UEANNA GIVENS o `". .=My G mission a1Notaty co - �;;, Notary Public-State of Flo Gd om h,la8on 2 �; _ m.Expires Dec 16, Commission No. S or;(S o��a ;, � Commission No:. 5� "o Gagqryry�� EE sbu7 1 °' �5' ht �or�mission# s %;•;,o;,`,.'' c % o:` Bonded Throng h National Notary ` ,m�'� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLEMANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014 Planning&Development Services ASBESTOS NOTICE Building&Code Regulation Division 2300 Virginia Avenue Fort Pierce,FL. 34982 Phone:(772)462-2172 Fax:(772)462-6443 Asbestos Notice to Contractor December 23, 2015 SOUTH FLORIDA LAND CLEARING INC COLIN M HALL 15701 ORANGE AVENUE FORT PIERCE, FL 34945 FILE RE: Building Permit Number 1512-0415 It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal law. Signature /2 3/1 15 Date 12/23/2015 2:52:30 PM i Property Card Page 1 of 1 Building Information 1—<1(I of 7)1 >1 Finished/Under Air Area: 1,188 SF Gross Total Area:1,688 SF Exterior Data Building Type:•' HD Grade: D Year Built: 1961 Effective Year: 1951 No.Units: 1 Story Height: 1 Story Roof Cover: Fibrgiss Shg Roof Structure: Gable Primary Wall: CB Stucco Secondary Wall: View: Frame: Interior Data Bedrooms: 0 Full Baths: 1 Primary Int Wall: Drywall Half Baths: 0 Primary Floors: Carpet Avg Hgt/Floor: 0 Heat Type: FrcdHotAir Heat Fuel: ELEC Heated%: 100% A/C%: 100% Electric: MAXIMUM Interior Sprinkler%: 0% "y�rt�O S a m �m CPX 1)00) (000) )e a m :............................... 009 Sketch Area Legend Sub Area Description Area Fin.Area Perimeter BAS BASE AREA 1188 1188 188 CPAL Carport Attached Low 500 0 90 This information is believed to be correct at this time but it is subject to change and is not warranted. ©Copyright 2015 Saint Lucie County Property Appraiser.All rights reserved. r littp://www.paslc.org/RECard/ 12/23/2015