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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 3kQ�� vg Perrnit Number: �Cpa'S OSrJ� �' . - . 1'. �0 MAR �0�6 -- _. 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 _ PERMIT APPLICATION FOR: RONNIED tN'PR+OUEMEN'T LC97CATI19 Address: 1 Y1e a rjW h n -- 2\,'Ce V-'\ 34 y Legal Description: �� v'V1 ��� eco-�'�S �O 3 C�• �� PC- see - cl, s0) 3--760 ) Property Tax ID#: cam- 3�� - �o © � - a Lot No. S Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION QF WORK: T�Q57- V�rf-\ cc�Y�r' - �W beY% % OYl \ CONSTRUCTION INFORMATION: Additional work to be pertormecl under this permit-check all that appy: _Mechanical _Gas Tank Gas Piping /X Shutters Windows/Coors= _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 10, 6939 y Utilities: -Sewer _Septic Building Height: OWNER/LE=�S�SEE: C®NTRACT®R: Name � o- Name: Address: � ` Q•O - 3(4Company: \7' \\rv-Y'�C�A City (z V-CSZ State: Address: l c Zip Code: LK Fax: City: �-'C� �.Y�C�. Stater Phone No. `72 2- - -2,3 Z - 7 l' Zip Code: Fax: E-Mail:q_ c)\/\ h S-o ✓1 -1 C4 Phone No Fill in fee simple Title Holder on =Q!age (if different E-Mail- o.111P&, .k) e'ys)Vic,Z , from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. StJP ......NTAL N64Z _{l1GTIt N L EN LAW I'NFCIRM TION: 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. 3VIA SilYnatureNQf Owner/Lessee/Agent Signature o Contractor/License H der STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5,\-. COUNTY OF S�• -plc\� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this�day of 'Ma-( 20 W by this !*, day of VNA C 20� by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary—Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Prod c S Personally Known OR Produced Identification Type of Identification DEAN Type of Identifica io YP Slate of F oori a " Produced �L IQ�-- o PaY P °C;% Notary public 16,2016 Produced �If DEANNA GIVENS g Expires Dec State of Florida Comm #EE 858761 ;toy x o ary �.,� - ssion Notary Assn _My Comm.Ex fires Dec 16,2016 Commission No. -�5 b16 � `,� rr�o National ;" Commission No. - 99�� 858761 t' 5 ougr � �'- ,, - o; Commissioh A 011- p r8 Bonded Through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 712014