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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: �,n© n (0. RECEIVED - — Building Permit Application FEB 0 3 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 'w Address: 34a66- 44U0I'0U6 - -Legal Description: SViU L, ;9�V� ����e`�� a 7 L L 4 �— Property Tax ID#: 02/I�f 0 S �p D G sa�" �d Oy Lot NL:.j 4_2L_ Site Plan Name: Block No. Project Name: A A Setbacks Front Back: Right Side: Left Side: - v { & ti''Tk, a�"i %�2k L:.- �m'ti u1.� �t;'}�! a h�� '�4,a r� tt.�' ks���:.,%, ,�a �,��ij�sh.,rl>v �??•. �,;�M ..c.a � �i�i: ���___,,,.r' �itT; r7 }� L Yi a pp ,p c �••DIkyr».�+ '�^s. � hV}��•��EL''�s3� �`,�t„�n' °r ' t r , -U",a ...tc'vrl '� ''5eo:L". a�,.`.r».rca, .w:':. .ad-zti•:a-.yt'�3vr'aid,.`�".'.irt�•,5'w",'�',:'-.tom d' �: ' gar. #z re,.:c.�-°..u,d .A.,✓u�Fa' '' OCA 40& 561-721-5611 WHEN READY r;r {Si ASC r.,wS ' >� SP.3,y.•'Vit 9t1+r{+s,;+'Ai..N> M.. ;�e;�' qi5 � a9e>:y eb ,a G0( MT- -2, V,,, I ..�,tvx+t{i tr�� � J.. d 4 •.:Oa 3 C bi,' ,;:{, ` } sw4�stg"t},i`"tr' ' aitrtat �.Fi Yf �� •a '� T^: x �' dQ�f7lT•. ...e.."a,...,,t, -:a l..ro S14Y• 4 •«ar..:l.4E.r Jr.•\S S q, ��fr.. 1 itiona worK to be erformed under this permit-cneCK III appy: HVAC Gas Tank ❑Gas Piping _Shutters Windows/pat 11 Electric 0 Plumbing Sprinklers El Generator Roof -Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ 1� \ . �g`�-- Utilities: Sewer El Septic Building Height: 4 �PaT ����ar A ""N,�.4•�'` 'S'„�t t`r ��a A 'ot�> k .. ,� ,a... �Pi .,<•i¢ 'r51; X,f" t � 'E5 V^,Yr@i�I`?'.�...,r �.....aJ��Lh',��g1�,C��sh����a:�:3:,,t`d..6n`"�.3'��+.';:�1 •� it�' � �-k F�?, � ?5' S��"r•; '-s Name �r- Address: SG LJ 5W Q_01y7AAA2S'r Company:__T-4_(o 0Qf'Q�r�- City:R(5vt Sk I vele State:EL Address: %as to l -79 T+i Zip Code:_:3 Ll 9 WLC Fax: City: I,0, -kvti 'cel State:_FL Phone No.-7 7 A• 9-x-9 S'_ Zip Code:31L4 I a— Fax: 5-61 .la's`s•CAD� E-Mail: Phone No. 51P!- Vs-,5- ! -j 05- Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: G 0 0 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. �`' l ti:•�ME�.+ i K'iS R� Fd" 5 ., '..w(€'� �t'z" iFS o n'+:.yt +r$. .�,^ it ��. �1�1 .I + teS�!.•,w�S(r .""` �..}} t1• , },...y,. ... '!aRA JY mF�.Lah.'sy f.'I.+, tL,i.r: w�un,t. '`.>fr.cSsw,...i, 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 theermit 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 Hamie 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. A .� u 1 �- S. I —Signature-of-Owner-/Lessee/Agent 12%haffreWContract-677ILicense Holder STATE OF FLO 'I STATE OF FLORIDA /� ��C COUNTY OF �� -G COUNTY OF }� f� The f g ins ent was acknowledge before me The forgoing instrume t was acknowledge before me this ay of 20 LUby this__� day of 20 by xeh r - ,� KNe of person acknowledging) S>;9ESi dduolsslww (Naa knowledging) Boold to eIBIS'oIlqnd ti ON Z nDRlGoH sima .�_ v e�f.Not ryE,G icy5tate of Flo ) (Signature o otary Public �-State Florida) Personally Known �� OR Pro a entification Personally Known ✓ OR Produced Identification Type of Identification Prn&ced Type of Identification Produced Commission No � (Sea k®-10 Commission NO. ot�tvruef/ ANGELAYOUNG * o* MY cO&IAUN#FF 951069 Nf Q EXPIRES;AprN 12 2020 "yl Q� Boom Thru Rudge N&ary&ric8s Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS