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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ' Date: ` .,' 1((2 Permit Number: REC ' [� [z Building Permit Application MAR 3 12016 Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie County, 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 ` O© PROPOSED IMPROVEMENT,LOCATION Address: 3 ?_l 3 � ,b l�cl al7oL Cl-t—. POS fit �� . ( Legal Description: f7h Cf'i(�� — yok-f �D-� / ( a2 3-.3/ - /�i /A Property Tax ID#: 3Y 2,f— "? DO — D 2 Z) Os' ' GUd Lot No. /0 Site Plan Name: Block No.-2-0 Project Name: r-7 Co— Setbacks Front Back: Right Side: Left Side: -DETAILED,DESCRIlPTION :OF WORK: A�wwvc f4F SWIZ. 4A /U A0AJ- coy NSTRUCTION, INFORMATION: Additional work toa er orme under this permit—check a appy: HVAC E] Gas Tank r—iGas PipingOGenerator Shutters Q W' dows/Doors Electric 0 Plumbing ❑Sprinklers r2_Roof Total Sq. Ft of Construction: /y0 V S . Ft. of First Floor: Cost of Construction: $ �3�• CCS Utilities:cnSewer Septic Building Height: 0111/NERLESSEE,�:- CONTRACTOR: NameNameVJh 1 It. 7-(.t Name: S - Address: 0O/ Qlz(r— an IZ& Company: /21�v City: &%l7,fA4 State:Ay►G Address: /0Q/(F S: N Zip Code: OL/P// Fax: City: 07T Phone No(,Dt), g'// eFGI e3 Zip Code: �� q,_Fa Fax:_ ' 211"1 E-Mail: Phone No.,-Z�-- qny Fill in fee simple Title Holder on next page(if different E-Mail: r_T- ,l a .Gem from the Owner listed above) State or County License:_C_6(tp 3 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. y ` SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION`.` 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: 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. s -�/ s _Sig afore of-OwrTer/-L"ess %Agent Signature of Contractor/L'i. se-Hoider STATE OF FLORID_ STATE OF FLORIDA ,'n COUNTY OF Wl. G L!/ COUNTY OF � *- w4 U[ The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this2&'Vay of &4Civron 20/J&by thisR&day of MatZh 20 A by i el S. 404An erdd CS. 4(0,0r) (Name of person acknowled ' g) (Name of person ackno�wwll�edgin (Signa re of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known. OR Produced Identification Personally Known III OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No.P 6169 7 (Seal) Commission No. � 74602Cj (Seal) Notary Public State of Florida Jennifer avis ro c to Florid My Commission FF 888029 Jennifer Davis Revised 07/15/2014 ? Expires 02t29/2020 ' �' Ex Commission 02/29/2 FF li80029 a Expires OZI29/2020 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS