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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� Date: a7 Permit Number: " com 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 J PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line poor PROPOSED IMPROVEMENT LOCATION: Address: I075/ S a� Dr;ye A9, Jemy w Reed, FL 3*57 Legal Description: [ 37 'W G-r.;.4 5ti/ Car Se /a-37-X RI&I /✓ W ,0fG�S / /t/ /�' �e LE AL6, S5Z- LT7yy/ FT 70 -/-/ AIA, Tff41 23 DEG Y9 VA-1,;l' SECALA ' s.//- Property Tax ID#: Lot No. $_ Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION.OF WORK: Remove G1�t14 !`ep/�PCe 4Wo eg}er/or Weol� w)71) CONSTRUCTION INFORMATION: Additional work to be erformed under this permit—check all appy: HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors 0 Electric 0 Plumbing Sprinklers. E Generator 1:1 Roof Total Sq. Ft of Construction: Al LA Sq. Ft.of First Floor: �_ 11A Cost of Construction: $ 75-0,Z? Utilities:0Sewer ElSeptic Building Height: OWNERAESSEE: CONTRACTOR: Name 7; .m /tfpse(' Name:_ key-' ► --//R_ /(A csiGlS2e Address: /075/ '�, /�ivgn) nP,'ve A� Company: '!5 r City: cTAJ5-e- J (3e IC/ State: FG Address: l$gd jF 4freV4e(7"y PU �I;le Zip Code: S q9S 7 Fax: City: 894 05 State: FL Phone No. 7702 -�l�S--r;?©� Zip Code: �}1��3 Fax: 77�-6 E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: tK eX�e�Sr<orCDrtJS7�/u�io�NP� from the Owner listed above) State or County License: 6665-o?J 9� If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCT ON 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 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 or recording our Notice of Commencement. s _Signature of ner Lessee/Agent Signature of C ctor/ (cense Holder STATE OF FLORIDA . STATE OF FLOAr- COUNTY OF �w.�x� , COUNTY OF L_L. 6e, The forgoing instrument was acknowledged before me The�Nay g instrument was acknowledged before me this� day of �,�s-� 2d(2 by this of 20 Ito by La MCT�40Q'Wfll _V1 I to (Name of person acknowledgin ) (Name f person acknowl gin ig ature of Notary Publi tate of Florida) (Sign ure of Notary Kubikc-St to Florida ) Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Produced Type of Identification Produced �tLo �,,�� n ,.,� LASHAHNA INGRAM Commission No. ,.��t"a °ac'•, „ N( g�l�ublic-State of Florida i Commission No.0 L ARTZEL •; ; My Comm.Expires Dec 20,201 E MYCOMMISS ION 9EE134915 t nn da FF 177249 •. �;? EXPIRES:January 30,2016 u;o • v ,„, u c n enm ers � Bonded through National Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS