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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: A ©c;� - ;,-fir 7(-- RECEIVED ....... .. .Ml Building Permit Application Planning and Development Services FEB - 4 2016 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 l?ROPaSED IIUIPRUUEME11tTaLOCATI{ N ` .. Address: lc>04y S DC. iJ TJ►2,IJ ' 7oSo Legal Description: SeAW IN105 ecivo 7 A1'rr -70,6 QVZ 10'7 9- 13 ► 1 Property Tax ID#: K roZ - 801-(- 005-44 —CJS-Lf Lot No. Site Plan Name: IG02'0&'a-A Block No. Project Name: KV24zI(0� Setbacks Front r4ilr Back: N Right Side: N Left Side: N A- DETAILED DESCRIPTION QEF 1N()RK SYAZt. IU&1 w1 N✓JW W,7-g- eXi S ITtNb -ChTTbtJ CO 'ST.RUCTR?N ENFORMATION'- Additional ditiona wor to e e orme under this permit-check all appy: HVAC Gas Tank -las Piping _Shutters Windows/Doors 0 Electric 0 Plumbing Sprinklers 11 Generator Roof Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ Il'01�IOU� Utilities: Sewer[]Septic Building Height: 0.1NN'ER"LES'SEE � CONTRACTOR r` 'e Name ( S Name: inl Address: CZ 7 S 4-ftwNL--C 10", Company: ��lS�T1 f��W�,t-+ u 041"Um City: rXAhJr_t_A/J LA'I6,E S State:_&T Address: L720 ro FC►7�r? C_ Zip Code: 0-71411-1 Fax: &q Z - f17'•t N City: (Q+A?n� State: Phone No. 'L7�1 �9C—Q, Zip Code: 34Clcfq Fax: (AZ-97c(`f E-Mail: Phone No. LA Z - 6LA10 Fill in fee simple Title Holder on next page(if different E-Mail: N«M#&L 600 owd." 62 from the Owner listed above) State or County License: C f Cb K if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIC}N DESIGNER[ENGINEER: _Not Applicable c pp MORTGAGE COMPANY: Not Applicable Name: ,)eh f )o`c+ P.&-. Name: Address: 1 :3y Skin Sv-,}e_ Iol Address: City: C,I.p0.,rv_,c..4tr IPL State: F'L City: State: Zip:33-1k,v® Phone:(-)Q3) 3a - .9000 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 thepermit 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:Y r fail to Record a Notice of Commencement may result in your ying twice for improvem is to r. pe . A Notice of Commencement must be reco a an ed on the jobsite before t first ion. ou intend to obtain financing, consult ith n r ttorney before comm i w in our Notice of Commenceme S ignature of Owner/Les e/ ent S gnature of Contractor kens older COUNTY OFSTATE OF COU � COUSTATNTY OFE OF ORIDA �r,d The fof ng in w ac nowledged before me The for ng instrum nt as acknowledged before me this / day o � 20 �iby this day 4 20 L by ( me of pe on ackno a ing) (Name f pers owledging) j ' (Sig ture of Notary Pu ic-State of Florid (S' ature o Notary Publ' -State of ori ) Perso Known OR Produced Iden tion P rsonally Kno n OR Produc Iden ification Type of Identi i roduced I Typ Identific tion Produced Commission No. �� (3GG (Seal) Commission No. �uJ�I ' (Seal) �PopV P' 10HN LEE TiNN1+__ quupp, No Public-State of Florida a a°. .`�; Notar% y Public-State of FloriJAN Revised 07/15/2014 '* '?MY Comm.Expires Novi 15,2018 '! :•?My Comm.Expires Nov 15,2 CommISSIOn#FF 1653 °;� Com Bon ed through National N�tary Assn "� " Bonded t rough National Notary REVIEWS FRONT O I G S GROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW. REVIEW DATE COMPLETE INITIALS