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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f , f ,Q� Date: ZZ Ili_ Permit Number: ISJIJI v r _. JAN 2 12016 F iFPMHTTING Building Permit Application . ;`.aunty, FL 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: �C) P,�R,��,P,©S,ED I,N�P,�R�UEM.ENT LOCATiIQN; . Address: -tLL-;,:, L�� Legal Description: PropertyTax ID#: 24 -11200(�7 6L)OK Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: - Right Side: Left Side: QE AILED DE�S�CR±IPTION UF.VI/ORK; GONSTRUCTle 1NF®R1ATION: Additional work to be peffo—r—m—ea 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: : Sq. Ft,of First Floor: Cost of Construction: $ Utilities: —Se ver _Septic Building Height: C®7�1NNiER/ILE�S�SEE: C+ONTRA�'T©R: Name R *iur �L'z stn/ r2a-rz Sr Name- 5T vim VQ Address: `i SIOD �5f�rr�k—" 2 Company: City: 15 L,. Stater Address: 73'2.`t L Zip Code: '-l�t, �-r = Fax: City: `�� f'GP State: Phone No. 'I-7Z 7-(:l -7-? Y-7 Zip Code: �qLV'7, Fax: -7-??— E-Mail: '?LE-Mail: Phone No '7`)Z cl 114, '-601LE-7 Fill in fee simple Title Holder on next page (if different E-Mail" from the Owner listed above) State or County License CC&Ci.i S "73 /i02.9!J If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S`UI F.,IEMENTA. CONSTRUCTION LUE ' LAW I1NFORMATi s DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: y-1-14 D�y �Y✓ Name: Address: - 20, Iaw SG' ""14 Address: City: -PS L IState: ( City: State: Zip: 3—iS� Phone GAG S 'o 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 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 i9soction. If you intend to obtain financing, consult with lendefln attorney before commencing wdrk or rgcording your Notice of Commencement. Signatu a of Owner/Les ee/Contractor as Agent for Owner Signature o Cont ense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF Uic a r,. The forgoing Inst ument was acknowledge before me The forgoing instrument was acknowledged before me this -day of 20% by this ; y of 20 by /` 1 � 0 (Name of person ac nowledgi ) (Name ol person acknowledging) 1 (Signature of Notary ublic-State of Florida) (Signature of Notary•Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced ced KAREN S. NIELS N ,, EN S. NIELSE Commission No. _ ,beggmmissioo H FF 115 ission FF 156 My Commission Expir ission No. ""Y" (ga y Commission Expires, xpi es * 1 ,'ql Of Rio, +� s June 12, 2018 o;'Eo June 12, 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.