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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i Date: Permit Number: I lQ� � ( ) m a ' Building Permit Application MAR 14 2016 Planning and Development Services PERMITTING Lucie County,Building and Code Regulation Division St. FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PRO POSED]MPROVEMENT LOCATION: Address: '5�2 03 'S' -I-ad u lit.n rqJ,Ve Y- Legal Description: 5 O FA IIS SQ S _Iq•I to Fr of 1-a-t 3 L`1G E OF FC(_ RR P)LQ-LASS PD RU - C oR 3(D i q - tigy -) Property Tax ID#: 3y D I - to 00 - O 0014 — 0" 0 p Lot No. 'f Site Plan Name: Ur DccX-- Block No. Project Name: Vt\r 'M DD (_- Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: los-)&Ilaj,'oyn of docs. Dec r, c-0-1 Phish'n5 C) 0CX— CONSTRUCTION INFORMATION: Additional work to be nertormed under this permit—check all appy: HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors ❑Electric ❑ Plumbing OSprinklers Generator ❑ Roof Total Sq. Ft of Construction: SFt. of First Floor: Cost of Construction: $ rl O0O- 00 Utilities:cn Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name7i t- ikir Ee r Name: rn6-ona Sr, Address: 050 Qowe i 1 It Roa d Company: —Jo-es 1✓lec;fY is 0t 94 I IAC le-8A211 rX, City: A 0 oc W a 11 State: Address: C1151 K)o w r P lac e— Zip Code: 3603D, Fax: City: �o r 1- PI e-ru State: FL, PhoneNo. 70'7 330 •a9a91 I913 7�?7-3538 Zip Code: 3LkA�--2 Fax: PIA E-Mail: Aeili r). �LAr ker® (_D p4r-}-,CV M Phone No. -7a 1465-234P3 Fill in fee simple Title Holder on next page( if different E-Mail: 1 QCSeJe_L& -1yLie l' G.0),Oa m from the Owner listed above) State or County License: 295 .7I eC 13007190-3 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION.LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: NI A Name: /VIA Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Ai/A Name: n/A 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 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. J c s _Signature of Owner/Lessee/AgentSignat a of ntractor/License Holder .n� STATE OF FLORIDA ATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20 _by thisday of 20,�(,by 1 (Name of person acknowledging) (Name of p7efrson acknowledging) (Signature of Notary Public-State of Florida ) (Signature oftNotary Pub�lic State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. (Seal) Commission No. RANDOlPN MCDANIEL Y ©�5� EXPIRES Septemba 07,2019 Revised 07/15/2014 , `� ® 3- REVIEWS �,o:i�o-o+s� Fara.r .,,s«m..�„n FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY —Not Applicable Name: N/A Name: N J A Address: Address: City: State: City: State: Zip: Phone: Zip: Phone- FEE SIMPLE hone:FEESIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY- Not Applicable Name: N/A' Name: n./Gr 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 Association and review your deed for any restrictions.which may apply. In consideration,of the grantingof 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 toRecord 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 comme=ng work or recording our Notice of Commencement. 5 _ ature o wner/Lessee/ 'en . Signa a of ntractor/License Holder emAd .f STATE OF FLORIDATE OF FLORIDA < COUNTY OF .7-77 Z u e COUNTY OF The for o'ng instrument was aeknowledged.before me The forgoing instrument was acknowledged before me this&nay of `Y?AW6�/ 20�4by this,�day of 10 ,20/�by (Name of per on acknowledging') (Name of-p-son acknowie'dging) (Signature of otary Public-State of Florida) (Signature o Notary Public-State of Florida) PersonaIly.Known /� OR Produced Identification Personally Known /_/OR Produced Identification Type.of Identification Produced Type of Identification Produced Commission No. Commission No. ,,y, DO MCDANIEL -; • RAMDOlPH MCDAN�4 ''' ::W1 M ISSION 1t FF915804' -� %'=8 2 - EXP M Sapt�mba E7,.201! Revised 07/15/20 +b� "''i> +±" '' ' - i r;�o+e� war. a.«�. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS