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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO WST BE COMPLETED FOR!APPLICATION TO BE ACCEPTED Date: '`1� �(� Permit Number: i RFIVE Building Permit ApplicationMAR -3 2016 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 PERMIT APPLICATION FOR: v Address: Legal Description:. S Sk L r { �- Property Tax ID#:-t-_�o (0 ° ��b Q4 ^ ©� } Lot No. Site Plan Name: 4 AAJ I Block N Project Name: Setbacks Front Back: Right Side: Left Side: 1A Additional work to be pe orme un ert is pe mit Rchec all t at app y: —Mechanical _Gas Tank Gas Piping —Shutters ><Nindows/Doors Electric —Plumbing ,Sprinklers —Generator Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $� D _�' Utilities: _Sewer _Septic Building Height: Name c--n e vv��t/ Name: f".it .(2ac l.'_o Address: & be, S Company: � w e r City: elrc-e_ Stalte: Address: Q - 1 913 Zip Cade: Fax: City: 0,k-1 {� State j� _ Phone No. 2 '-�YZZip Code: 7) 2-�-7 Fax: E-Mail: Phone No. 40 7— 0 3 7 ' b UdS S Fill in fee simple Title Holder on next page (if different E-Mail: from the Owner listed above) State or 6erty License: & C- P o q 17 Ecu L If value of construction is 2500 or more a RE ORD Na 'ce of Commencement is a tred. SUPPLEMENTAL CONSTRUCTIO'N'IIEN LAW INFORMATION: QESIGNER ENGINEER: Not Apolicable MORTGAGE COMPANY: _ _ Not Applicable Name: Name: Address: T Address: _ City: _State: City: ___ State: Zip: Phone: Zip: _ Phone: FEE SIMPLE TITLE MOLDER: _ _ 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 Osociation 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 respect perform the work in accordance with the approved plans, the Florida Building Codes and St.Lucie County Amendm t The following building perm' plications are Exempt from undergoing a full concurrency revie : r m additions, accessory structures,swi inJur pools, fen es,walls signs,screen rooms and accessory uses t ano er non-residential use WARNING TO OWN R:Y fai re t Record a Notice of Commencement may r suit' your paying twice for improvements to y ur pr per . A N tice of Commencement must be rec r ed a d past n the jobsite before the first ins ectior , I you int nd to obtain financing, consult with I der o an a orn y before commencingwor or rec din you. tic of Commencement. Signature of Own J Agent/Lessee Signature:of Contr .tor/License Holder STATE OF FL IDA STATE OF FLO DA COUNTY OF ANNE __. COUNTY OF on +�� i The fo oin i strume as ac wled e fore me The for oing ins u was< owledge ore me g g fa this day f 20 h}` this day o 20 by 1 i PETER A CAFAR6 Ut Pt:TER A CAFARU iii (Name of person acknowl (Name of person acknowle ing j ( igna®r'e f Notary Public-State of Florida I (Si nature o Notary Public-State f Flor da I Personally Known x OR Produced Identificati'pn Personally Known x OR Produced identification_ Type of identification Produced i Type of identification Produced Commission No. EE 174164 +rYi mmission No. EE 174164 �a(, ,o,LWI'C State of Flor"a�y<. Y Pik. Notary PuAIic+State of Floridn ; Kari M RiCCabOni 1 �+ Kari M Riceiiboni 9 My Commission EE 174 t 64 } a o :xpues 05.+2 2016 of noA xpies r26+20to, of Ro Revised 07/15/2014 My REVIEWS FRONT ZONING SUPERVISORPLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS - I