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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: />; Permit Number: 409 'o-Iy Building pp 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 Res idential . PERMIT APPLICATION FOR: P�RtJPO.SED IN;RRO.UEM�ENT LOCATlfi_ : Address: __�`10� Og9CI '2��1C �' (ALU Q Legal Description: Zi heyOC)Cl re. (� - U rl;t L Le) -t- Property Tax ID#: ca 7 -oc-To -C)o Z Lot No. _ Site Plan Name: Block No. :23 Project Name: Setbacks Front Back: Right Side: Left Side: I, roma E 'ANLED DE5CiiIPTI©N 01=LIVOR Crccf- g '-7-'G (( wh,°4;f- L/ti'llI--f-or-1 00CA'A GG'gt: resiJ61 OY I COIUSTR+IJ 1"lON IN}FOR11/I TION: Additional work to 5-e-p-efformed under this permit-check all that appy: 1 _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:$ 1 (G 0 Utilities: —Sewer _Septic Building Height: ®V1[#N =1 ff�SyEE: CO'NTR>A(;TO JR: Name Ireltr cl'' o'6-ic V'\ Name: ,! Afi�/Gr-) 19oye-c- Address: (Aso '2&'S� g LV n 'Company: �r�s 9eC'� t'�n�e , LLC, City: State:EL_ Address: -7` ' 1 IV. M'telC� Zip Code:-3kg S- l Fax: City:_«c(* 6cGC1NI .II1 Stater Phone No. 2-0(2) Zip Code: 32966' II Fax: E-Mail: Phone No 272 - 321 -- 7fZ Fill in fee simple Title Holder on next page(if different E-Mail S-,r�Ste�ci3(j (,��a�;l •Gc�✓'� from the Owner listed above) State or County License �. If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. FOU RII @MRTI;iCONSTR+UCTION LIjEN LAW INFORIMATI'ON: 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. Signa ure of Owner/Lessee/Co ract s Agent for Owner Sig ure of ntract /License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Slk ,1-4 COUNTY OF S•�t 1131� Thefgrgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this �P day of ft\Qr,,,,h 20_16 by this 4-day of MQL�k_h 20-(6— by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) Signatur"Notary Public- ate of Florida) Personally Known OR Produced Identifications Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced lQ� Flo �l Ito-'d 1p�3.1410 '�I 7�ib Commission No. ASHAHNAIC mmission No. (Seal) State of plot dAB Notaty Public- Dec 20" .=My Co on#FF 177 � SAar r+�� �. REVIEWS FRONT Cogar As NS VEGETATION : _E (�TN�tary PNtbVC:c a COUNTER, %aiww Bonde t r REVIEW REVIEW K y Co m '� EW,t 20 8 Com issi h d 77249- DATE ` %;t t"'�` Bonded t irough N dl Notary As n. RECEIVED DATE COMPLETED Rev.7/2014