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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:_T`�� Permit Number. m 0-R-d13S RECEIt'-H FEB 24 216 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 --k/-- PERMIT APPLICATION FOR: I� PRa'POSED EW",MENT 0001TI©N:` l Address: � � Q�E'��^ (VN C 030- �0A , P(L( 2 �\ Legal Description: (7C Property Tax ID#: 1 ?4 Sq - 70 I - QaQN - QQ0, Lo o; -2QI TT Site Plan Name: Block No.�D Project Name: -) IJ Utl�r�a' I C' ` Setbacks Front Back: Right Side: Left Side: F AILED DESCRIPTION0&WORK: �n MWNW� M, I o _ . it onal work to be performp 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:$ o Utilities: —Sewer —Septic Building Height: T OWNER/LE�S�SEE: CONRACTOR: Name'} eA A�Nkj,1-e IAL Name: Z&NA-L B1 Address: _ Company: City: State. Address: 2 Zip Code:3!:�q 99 Fax: City: State:T( Phone No. Zip Code: Fax: E-Mail:_ , 1 5sG Nc.�6L. c6m Phone No 41,I, (9- . ,_3-5-92 Fill in fee simple Title Holder on next page (if different E-Mail J�1SS G \� kl CC)M from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. / SU�IIEMENTAL C%F STR±U ATI1 LIEN LAW INF©RMATIOtU: 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: 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 inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Sign a of Owner L see/ gen Signature of Contractor/License Holder S E OF FLORIDA STATE OF FLORIDA NTY OF COUNTY OF The^for1 going instrument was acknowledged before me The forgoing instrument was acknowledged before me this�day of 20\6 by this day,of 20_ by ��.'r, a%-CIA (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pub ic-State of Florida ) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification LType of Identification Produced �-.D L DEPNCA s`�e ot16 20� Produced 4 s0 Commission No. ^L, o`�'m'u N� { ExP`�e EEg5a�61s mmission No. (Seal) Co # o�acy F n 2, ,�,,_My Gomm1ssio NaC�ona1N co�9h BON- REVIEWS 9 E OF f` C REVIEWS FRONT "Z04011 SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER'"``°REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014