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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: d Permit Number: �. RECEIVED Building Permit Application JAN 21 201E Planning and Development Services PER°uiITTING Building and Code Regulation Division 5t.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 PROPOSED IMPROVEMENT LOCATION:. r Address: 35001 Legal Description: O Frim RC- S/g) All of S/0 - Less SCJ C46 1 454 ZZ � Property Tax ID#: ZYC>1 e>601 - ©00 Site Plan Name: 1 )114' B ock No. Project Name: Z/kh" Setbacks Front Back: Right Side: Left Side: �^ DETAILED DESCRIPTION OF WORK: - 5 5 p � �c { A-5 kik S CONSTRUCTION INFORMATION: Additional ltiona work toe ertormed under this permit-check all appy: HVAC Gas Tank E]Gas PipingShutters Windows/Doors _ Electric 0 Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: fit" S . Ft.of First Floor: ��j2� Cost of Construction:$ 9 G Utilities:11Sewer Septic Building Height: OV1/NER/LESSEE:. , = CONTRACTOR: Name C--dwin ab A(ie-%w Deloo�e, Name: �,Ae - KcAr,4kre s Address: SQQ1 -- Yndian Qit,rr or. Company: ,A City: PI. P e_r c(_ State:11 Address: 2GW tiej1,>`ti sk o- ,- Zip Code:36$2 Fax: City: Sc.nf<'rd Stater Phone No. F 757-7-- Zip Code: :?.I 1 Fax:_�(O� • 27-- Qvro E-Mail: -ez- Phone No. LJO - - Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License:._���d�-� '?, If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. may, Ex W ? 7 ' ' .TJX DESIGN E�ENGINEER: of Applicable + MORTGAGE COMPANY: I f Applicable Name: Name:--..-.-.. "Address: Address: City: State• City: State• zip: Phone: Zip: Phone: FEE SIMIPLITITLE HOLDER: , -**"Not Applicable BONDING COMPANY: _L-lqbt 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 Couq makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in con ict 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 k4th 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 commenc:W work or recording our Notice of Commencement. . s _SigAu - LesseeJAgent Signa ure of Contractor/License Holder STATE OF FLORIDA STATE OF FLORMA COUNTY OF COUNTYOFsarn In o The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day Of 20 by thi�ay of"�d ..._..�201 by {Name of person acknowledging). (Name of person acknowledging) (Signer (Signature of Notary Public-State of rida} Person ' ' ^ _ Personally Known/ OR Produced Identification Type c. "x, ) 1 � ' � �C� Type of identification Produced Comm Commission No.. - -1;T-7-3 , ,, s DA ]EMERY ' �'cvs�d`' EF1'IRES:danuary26,20t$ ?9_116si—ii FPO Revi REVII 7R PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW DATE COMP INITIAI a