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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / Date: � —)V ��O Permit Number: / 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: OPOSED GIUIEPR©VEMEIVI LOCATION: PR Address: 125 Ile # e,5 [vJ hi-en Ac4 /CG• Legal Description: Zrliod 7'nz C220/ '/3� lJ) lJ7 Property Tax ID#: V5 ' 5'0/- o)77—000 Lot No. &.� Site Plan Name: Block No. Project Name: H3 x/e fides Setbacks Front Back: Right Side: Left Side: DE1'�A`TLED ®`E�SCR iPTION a O'R+T<: RawWA aillm ,p/e�e Aemo 11'/;an cr'no elipova/ of 7161 s�.. P CONSTRUC+�TIO�N UNFOR++MAT ON: Additional work toe e orme under this permit—check a appy: HVAC E]Gas Tank Gas Piping _Shutters Windows/Doors Electric ❑_Plumbin-g []Sprinklers Generator Roof Total Sq. Ft of Construction: ! /b S . Ft.of First Floor: 71 o Cost of Construction:$ /700,00 Utilities:cnSewer®Septic Building Height: ,1NN!ER/LE�SS'EE: I C®N�TRACQ Name�olin d' eii7a/V)) �llO�-er_ i t Name:�.n ���fii fLi Address::/gS /Vi�>�/eJ .,�iv�/• Com an ` D p y �����,i`�► .Setif/+ ,UO cc, 5y-c-_ z-9,-- City: en fc'.iGni:' :: State: test J/ Zip Code:-.}y y.j 7 " .:Faz City: °L):eh Len:.- r '6�.. State:A4 Phone No. D/ "�9 3Q09 Zip Code:- ' 'y°y9 7` ' Fax: 77;_-;-3)--,-/9/ E-Mail: Phone No. 772- 284- J7/3- Fill in fee simple Title Holder on next page(if different E-Mail: 4aaM5Mi e-V- YriLio9 e2, from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 5'UPPLEMENi'AL C©NSTR+UNION LIEN LAUII IN!FORI�/IAl"IOfV:mm 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 wor_k o ecordin r Notice of Commencement. s _Signature of Owner/Lessee/Agent Signature of Contractor License Holder STATE OF FLORIDA _ STATE OF FLORIDA COUNTY OF 1OL COUNTY OF 1dL The forgoing instr ment was acknowledged before me The forgoing instrument was acknowledged before me this day of 20��by this I day of 20 by &MCI tion cS (Name of person acknowledging) (Name of person acknowledging) (Signature 3f Notary Public-State of Florida) (Signature of Notary Public-State of Florida) n l Personally Known OR Prod=d Identificationy Personally Known OR Prodiddd de ifipati Type of Identification Produced �uType of Identification Produced l�f Commission No. FFMlSeMIMBERLYA.WALKE Commission No.—Pf ) I�I&*LYA WALKER NOTARY PUBLIC NOTARY PUBLIC STAT OF Ell _0TA EGIFFILORIDA Comm#FF089371 Comm#FF089371 Revised 07/15/2014 W- 10�Expires 3/18/2018 A CE 910 Expires 3/18/2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS