Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 19qHECL QED JAN 1' 4 2016 ` Building Permit Application PEW41ITTING Planning and Development Services St. Lucie County, FL 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 \)(I �. PROPOSED IMPROVEMENT LOCAT,,ION: Address: 2 R (S .F(o-f;l(t -rprrcLQ_ S4 . 34T/S Legal Description: (^i0 gra L Cove. loeaC L'% - S ec:4 on O rte- L( (04 15O (n\r 3122 I°t 37 I Property Tax ID#: 1 7 01 - O L 1 CGo - Z Lot No. Site Plan Name: u11OW�`� Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK:. .: v4mov." f-e011pitl 4)6?q Re ca a CONSTRUCTION INFORMATION Additional work to be nerformed under this permit-c ec a app y: E1HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors 11 Electric Plumbing Sprinklers E Generator [] Roof Total Sq. Ft of Construction: 1 s S .Ft.of First Floor: nn o0 Cost of Construction:$ d Utilities: Sewer Septic Building Height: 01NNER/LESSEE CONTRACTOR: k ,, Nama U�2,b� Name: ( Lo _ Address:17-W'S 1:1" a -IQ_yy-c�c Company: N�fs ��d N'TILA�� NC'1 City: 4, 1p-\&(2 State: (. Address: 0 $O 21 S7 Zip Code:'3y 9 y c1 Fax: City: 4• ?l State: Phone No. Zip Code: 3qq-) Fax: ''i'pt E-Mail: Phone No. 72_511 _T 015 Fill in fee simple Title Holder on next page(if different E-Mail:r11Qa16rop6 nn �/G�•h0�1CcsV�ra vrti •Carr► from the Owner listed above) State or County License: CGC(5( M If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN.LAW INFORMATION: 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 Count, 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 OWO:Your failure to Record a Notice of Commencement y result in your paying twice for improvements our property.A Notice of Commencement must b r corded and posted on the jobsite before the fir 'nspection. If ou intend to obtain financing,consul h lender or an attorney before commencin ork or o ig your Notice of Commencement. s _S g e e see/A t Sig ture �ctor/License I er S ATE TATE O ) _ 0, r OF COUNTY OF �cn e, The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this lit day of CL;l,L lA 20 -Lioby this day of ou"u-0, 20 by nil ; ikIo,,Ad �-©�_ � rcjlj wj'L-6p. (Name of person acknowledging) (Name of person acknowledging) In O' )-LLA--,_ Z (10. L (Signature of Notary Public.State of Florid 1 (Signature of Notary Public-State o Florid a1111111111/� SABRINA BLACK,��gtll�� 1111011it, ,N NP� BLgC Vi//iii Personally Known OR Pr c ¢�dE� Personally KAe 18V' "(1�W6 Type of Identification Produced Type of Identification Produced �_� try 2.20,9•: Commission No. _ (5��� m�*s Commission No. JF 1!3633:A*i (Sea+)•5331 ?o= 195337 •�Q� i gt F 19 '�o Z #FF •o� .2 eandedm� ��• Revised 07/15/2014 ���j �e� S"(���� /��IO 11!1!1�. o"01` 11 1111 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS