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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 'S -1 1 �� Permit Number: i RECEIVED MAR 0 7 2016 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 X PERMIT APPLICATION FOR: PROPOSED INP.ROVE"MENT:,LOCATION : Address: 1300 W 1' Legal Description: `�1��1 1 e C ^fy 7.3 L o 4S 1 9 , 2,0 .2 4-2-Z V� Alla„ ��i © -� �� I -� �2 'y-r 1a l(ew, �.f k 04- d, n fiJ l� .2 6 .'z / t 2'L .G 9��re 3oOc�o S y ,F) e� 335' 23SS'8 r3—re�3 Property Tax ID#: �' b aj 5 0 , �- �c -�y100 - 42 Lot No. r ?-2- Site Plan Name: Block No. 7 3 Project Name: Setbacks Front Z, Back: Right Side: Left Side: PIONDETD } 9' !hr Ni U, .4P,-"c 9— WCL WCL G a n CONSTRUCTI,.. .amu ON INF:ORMATION .- . Additional wor to a pertormed under this permit-c ec -a 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:$ Utilities: _Sewer _Septic Building Height: OWNER/LESSEE �C ONTRACTOR Name Rk Name: SfaLl Address: .5 it Company: .S wi e-x `✓ efv +r' vej ea', , Ca• City: ilP i , State:I::-/- Address: 92 3- 7� z, AW Zip Code: 3 y &o, Fax: City: A* _5�2. .4 u rim State: Phone No. 77 Z ` 20/ Zip Code: -'-- V 9_ Fax: E-Mail: Phone No '7 7 2 3 9 9 o 0 f 2- Fill Fill in fee simple Title Holder on next page (if different E-Mail +4e wia H _j'76 6) i nvo6I , C ow, from the Owner listed above) State or County License C 6 CID f If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION• DES a: � IGNER/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 O ER:Your failure to Record a Notice of Commencement m result in your paying twice for improvements y ur property. A Notice of Commencement must bVih�tder d and posted on the jobsite before the firs 1 ection. If you intend to obtain financing, consult or an attorney before commencin or recording our Notice of Commencement. Sign of Owner/;L'e'ssee/Agent Sign u of Contractor/License Holder STATE OFF 111154 11; STATE OF FLORIDA COUNTY COUNTY OF Sk. 1 �c�� The f rgoing.i`nstrumerit was acknowledged before me The forgoing instrument was acknowledged before me this' day of Wlyy r 20XG by this _J_day of 11`no.^( 20 by ''(Name of person acknowledge g) (Name of person acknowled ing) f°- ;1 (Signature of Notary ,blit-State of Florida) (Signature of Notary blit-State of Florida) Personally Known 4rsonally Known OR Pr duGed Identi,is to ion state a s. c. s b Type of Identification ;gPKY Pia(;-- Notary Fabric' 2 1a pe of Iden ification DEANNA GIVENS Produced 1-� �- ==°w `°`_ y Comm.Expires Dec 16• produced L•Q, :=�^PwP`°''-- `; =_ _ EE 858761 -- ry Public-State of Florida �. Commission# _ k ' °. C I No y asn. - » • My Comm.Expires Dec 16,2016 Commission No.' - rfofF�oc Throu�hNationa-_tam. _. a $ ;N *J�, C ibe 4 on#EE 858761 �5� ( Commission No. d ima -y .,,[.p...c�✓'•�i..�.._ , of •• s:;�'-"""'' ' �fnm� ` Bonded Through National tJotary Accn a "1 '� 'REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW fl'ATE ',!RECEIVED DATE COMPLETED Rev.