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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO-JMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ,"' �J �/ O Permit Number: VIN Building Permit Application JAN 13 2016 Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie County, FL 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 IMPR01/EMENT L�CATIC? Address: 10S751 5 0e24,v? ��.-#13 Jensen 3 Legal Description: VI-h ',riJ �I/'r� G s Uh�h �09'�78 Property Tax ID#: 009-0- 04 0 — 7 Lot No. 13 Site Plan Name: WWJA1/// Block No. Project Name:_ WA1z1 1f Setbacks Front Back: Right Side: Left Side: DETAED D�SCI�tPTlO"N ®f OR�K: � a N. COnlr)k e- �a /l-7z'4n e7nl ller90Ila/ Of /V0&1 kwe q4W CONSTRUCTI®`N )NFORII/IP►TI©N: Additional work to be ertormed under this permit=c ec a app y: HVAC Gas Tank `❑Gas Piping Shutters a Windows/Doors Electric ❑Plumbing- Sprinklers Generator Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: 7,YX Cost of Construction:$ 1700 cn Utilities: Sewer OSeptic Building Height: F)C�4 OWNER/LESS : CUNRACTO'R: WASSOM NOW Name HQr7er 0'"E1Oyiq C/a.vs%hal Name: Address: 30J ,/// t14 P`1ena Company:&�.m J;;i�4h City:. /e 0 -4h e- State: Address: deft �: vghce� ��• Zip Code: Fax: City: &eic-A State: J'�L- Phone No. 190;` 5-717-0 y0 Zip Code: 31/9h`7 Fax: 772 E-Mail: �4JJR iyBY/&4,0 •c9M Phone No. 77)- ,2&--37157 '3� Fill in feesimple Title Holder on next page(if different E-Mail: M Sm ;'x @X­740 -cam from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 111111111''1 Sl1PFLEIVIENTA� ME IF L(.EfN IAW INF 111 1IATION::. 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 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 you intend to obtain financing, consult with lender or an attorney before commencing work orpecording ypurotice of Commencement. s _Signature of Owner/ ssee/Agent Signature f Contractor/Lic se older STATE OF FLORID STATE OF FLORIDA COUNTY OF U') COUNTY OF 4 • t The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me this 1,� day of 20 tU3by this_[�L day of 20 �by (Name of person acknowledging (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification 1//Type of Identification Produced �. h,Ly Type of Identification Produced Off. r"' .— Commission No. I sion No.r Sal ,�`,R•^°a KAREN S. NIEL EN - KAREN S. NIELSEN ?a e. Commissio,i # FF 1 5637 .`;o `�c., n 1563 June 12, 201 8 Revised 07/15/2014 MY Commissi """"'" '.F°., on Expires - �"������"� June 12, 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS