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HomeMy WebLinkAboutBuilding Permit Application r ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ('� Date: t/ Permit Number: / • 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: To Select from dropbox, click arrow at the end of line _!R'gyp. Address: 1,V Q n(n . l7_,) j Q6 1= �t=K}- o Legal Description: i`,5 4- /C1% 5 ��}i R �,�-�-� Property Tax ID#: 13 0(0- '-5-no' 0/ ao ` dam` Lot No. i Site Plan Name:�� Q �D lk h Block No. Project Name: `� �V) -P ni": Setbacks Front✓ Back: Right Si Left Side: Jta,•r,.:4...4ti j.-..�t f 1tip.rJ§ ti 4.,: ,�s �`r s.:r-�.tv `^`w_ 5...'. x"! t 'g i > _ y4i 4N�� A�s�:y JN .: ' s`' g! ,..... "" V+S,el-4`yro;,ir°'; DETAILED DESCRIP�TION�OF,WORK rY; se �?zt .ti, x,£ } } � u •L.M- ..R�9)y ",^4. Fw�..;.':CGf.a,ci:..�H'E. 1...`.,6Y>£-$Y":.. ?�v a)r!;'..... '�> �.Y�JI c:._w.Hr':'::w.�^3.�.3 _•n, ..\ ><.-'Wi."+c.§:�.k./4S,ZY"t1.�.e41nc.-'r..�.,F,.tb't.Y li,d IS- �Ka i ys O 00�C)Cd K §fir. �CONSTRl.1�C^T..orfi.§}.fN�.�'.I.NI$.i®:.E R•.,,Mr.i.v'1.�f.`FC. ION ii-a- •,r't.Y Additional work to 13e ertormed under tispermit-check all that appy: HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors 0Electric 0 Plumbing []Sprinklers Generator Roof Total Sq. Ft of Construction:--" S . Ft of First Floor: Cost of Construction:$ Utilities: _Sewer E]Septic Building Height: :fit c:. ,..+•w.-a.� xa;.Cs�t i. ..,r S. 5....._.� '""�„ ..uF+:..:..Ei.2,i ..Y,re�+,.. _ .ha. ..7. ,t5>. :...rl_r.._;.ue.,1, .nRi.f� �d.«.C��;_ .r.S',.«^vA.s i;[s.....^e.. a_a�,Lw*eft-. 1 C Name L) 7 oyA-) k)(� Cj_`._.p VL_ LV-)of )� Name: '�G'`uYa.�S� 0c.4Q`yS -- QlitA(i. -let Address: I q C)C9 --bI-) 101-; E ii L Company-7-1-4-co City: Ft. Al C'i L& ' & State:FC Address: %a a (n l • 75i Zip Coder U q: 1 Fax: City: I.0,Jh kvhPc-a C State:_'- Phone No. ` Zip Code:3SL4 I Q�-- Fax:_51,1 .SSSS•,C/LTJ E-Mail: Phone No. 5—b 105 Fill in fee simple Title Holder on next page(if different E-Mail: � — from the Owner listed above) State or County License: L (n L" ©a-a_FS'z I. If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. • :K-`Y4 ,C..-'.- i a�j's t �:.'�,w �i...rc.:;, 7," .« 4b .�;cr.i Vr e r�L r:..`..�, %4 tom,,.,!'X4 fit.,xr.L,,..�.. " ey.�,1."7{'A" r`c,,'^� d` t;. i 5 y 4� '_n-y {3 a Y u '`fi {..', . SUPPI EMENTAI.;CONSTRU { ION L`IfN AAkW,4N:h ,MATION0, a � Ty.. 1 DESIGNER/ENGINEER` Not Applicable MORTGAGE CO P NY: Not Applicable Name: Name: Address: Address: City: State: I I City: Stat6jlk— Zip: Y Plione: Zip: Phone: FEE SIMPLE TIL HOLDER: of Applicable BONDING CO P NY: t Applicable Name: Name: AddreWs., Address: City: City: Zip: hone: \..,1 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 gr2nting a permit will authorize the �irmit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or ana 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. J uAd AA Z�� S f-si, t .e-of-Owner/Lessee/Agent Si tore of ontractor/License Holder STATE OF FLORI,=[�L STATE OF FLORI��} � COUNTY OF _ Xl COUNTY OF f'G,`(lrpi/ _ The Tfoing instr e t asckno dg defore me The forgoing instru ent was acknowledgedbefore me thisday of 20, by this day of_��_ 20 -Y Y`.V. 115U VVI {Name of rson acknorvledgl (Name of person acknowledging) "-( at' re o,Notary'Public= late o(Florida) Signature of otary P blic-State"-KFIoricla} Personally Known OR Pr ced I nti i atiorvoy, Personally Known OR Produced Identification Type of Identification Produce T pe of Identification Produced Commission No. 0q, + e 1) MEUSSA PETER C fission No f A �S�11.A S 1d1G Notary Public,State of o1 Nt Commission#FF 21 =�: ::c MY COMMISSION N EE188835 EXPIRES ApiR ., 210-111 Revised 07/15/2014 (407)398.0153 FloddallotsrySerAcoxom REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS