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HomeMy WebLinkAboutBuilding Permit Application 1 ALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: LtJ Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34382 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PRtPOSED.IiPRQltEMET Address: C l, US RIWI,< A L VD, Legal Description: t,194-u/t,;�OD 1411k —44y)T 7 ~- 13Z X 90 LO r 2 g Property Tax lD#:- 1301 4D„ ti -U U D / Lot No. Site Plan Name: Bloch No. Project Name: _L44 TL, Setbacks Front Back: Right Side: Left Side: �EAILEI� ®ESCRlPT10� c�F it1lORK 3` `- ,, r 0 644 Y6,, X002 F1 17 COIVSTRIJCTION I N FO RM/'4T10� T x rx } stiona wor to e e Orme under this permit—check all tha appy: F]HVAC L----J Gas Tank E]Gas Piping OGenerator Shutters �WWAws/Doors Electric LJ Plumbing Sprinklers Q Roof Total Sq.Ft of Construction: SQ.Ft.of First Floor: .r 0 Cost of Construction:$ • U` �^ Utilities: Sewer L]Septic Building Height: 01lER/LESSEE K. "rF CONTRRCTCIR _ t ' Name_L,<C �4 -_7-14 �'�HY2TL /6� Name: 2#,,2g �,4Gru�rL Address: 1 U 1tL1i,V!G g JJwl �" , Company: 7-4c,4svg& rimu;r 6,*,e",g k Jga5 � City: 1.564T Fl—a rz C E F/.� Stater Address: W 54,154,1131 X 7*MeA,6;' ST, - Zip Code: �'95" Fax: City: `4e4 7 Sr, Av C,r t; State:F C Phone No. 332. — 7-I'll ll Zip Code: �?3 Fax: 979 67,61 E-Mail. /11.4. Phone No. 1?7'7 0"-7 Fill in feesimple Title Bolder on next page(if different E-Mail:l;?-ry re-&©e A from the Owner listed above) Sir County License: If Value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SU Pl.EM_EIVT C�( I STRUCTtItiD LIENl.A"WINFORlifl�tTlC}N t DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY ^Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: EEE Sli4 PLE TITLE MOLDER: w Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 1 certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure which is in conflict with any applicable dome Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit,t do hereby agree that t will,in all respects,perform the work in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing,consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner Agent/Lessee Signature of Contractor/Liegnse Holder STATE OF FL®Itt®A � � FLORIDA COUNTY 01� � COUNTY OF The for oing instrunient w s acknowledge efore me The for$ g instrument w s acknowledge !fore me this ay of Q�� 20 by this lay of Q .2qy (Name of person,acknowledging) (Name of person acknowledging) f ff�}1l CL� l t (Signature of No Public-State of Florida) (Signature of NotidPublic-State of Florida) Personally Known ' OR Produced Identification Pe sr onally Known.` OR Produced identification T nU roduced ,,i S"t`Y P�� ANt3ELA MAUFF . Commission No. (Seal) Co ss i Notary Public.-State of Florid all ;,. .•gcommission� *FF 234730 My Comm.Expires May 27,2019 NO nurr ��+++++•" Bonded through National Notary Assn. FRE-VIEWS No=a� State,of Florida'ton#f FF 234730 Mv Co _Xpigg$AARn ded through Nation Not SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS