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HomeMy WebLinkAboutChange of Contractor All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1D• Permit Number: /&P REC i,�-�t rte. _ B (ding Permit Application MAR 1 1 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: PRt�3POSE011 ROUEMENT L©CATIO`N: Address: 7507 1-4,ke5-,L wry.., Legal Description: PropertyTaxlD#: 1301—(o0a'000q — 0003 Lot No. Site Plan Name: Block No. Project Name: Setback"s Front Back: Right Side: Left Side: DETAILE© DESCRIPTION nF WORK: Lr1 I ry� r'-1 5:�� Q✓p/-Q �s�; [�"�en'F �v l W. � E �"Q 3 c V 3 ej hog >=�,�-�- s;J� �► , CONSTRUCTION INF©RMATIO'N: Additional-workto Be pertorme under this permit-check a .t at appy: _Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors Electric _Plumbing _Sprinklers Generator _Roof Total Sq. Ft of Construction: 2 Sq:Ft. of First Floor: Cost of Construction: $ Uy' Utilities: —Sewer _Septic Building Height: OWNER/LE�S�SEE: CONTRACT®R: Name 2 v�C1 �nr�miiJL Name: 11^44- ✓✓11^ ry �:►.� Address: '7-'507 LAbe5;Ae-C )0Le Company: G,�r��rw, �✓�g�r�.�ti o� City: 117')C4 PwCe- State: Address: ?o Sox �5­ 04L5- Zip Code: 30S f Fax: City: Vero ge 4 State I Phone"No. 7702,2ab-QJ7o2 Zip Code: 39g6C Fax: 7�a�9�8-5650 E-Mail:"V eep' k-eq^'l Ct}J�'l Phone No ? 7)_ q,7$ S(o s(o Fill in fee simple Title Holder on next page (if different E-Mail C,CLJ YUP c vV%- Tvaj'oh j��Q. W-n from the Owner listed above) State or County License-cc-c- lSl o If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTIQN LIEN LAW INEORMAM.TI(i DESIGN ER/ENGI.NEER: _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. T� o C C'SLU is Z. 0v�O 7Signature of Owner/Lessee/Agent Signature of Contractor/License Holder prN 66 ZSTATE OF FLORIDA �� STATE OF FLORIDA MLU � 2COUNTY OFg COUNTY OF nThe forgoing instrument was acknowledged befo 2 z The forgoing instrument was acknowleemov this day of / ��-�r— 20& by D6 this_&day of (� "'`�=1 ) '�N (Name of person acknowledging) (Name of person acknowledging) ( gnature of ary Public-State of FI ' ida ) U (Sign ure of Not y ubIic-State of FJ&ida) Personally Known_ZOR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /2014