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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u Date:'LA�����i Permit Number: RECEIVED APR 112016 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: YIN, PROPOSED OR,R,T R ATIt3N: Address:- -3S--3q �-LEu o�,J MLLU' P-D 3Z41.43-- Legal Z41.43'Legal Description:_4I._9y7Clt(AtMw - 7_L�J.S 5/D (,A L b'.35'31 Ar,. 209.Y4 : -S�zS`� drY coo 440) y/ 77,12- Property 7..7 .Property Tax ID#: / &1201 4619 Z6 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�SC« IPTI©N OF 1NORK: 10 'UULD O,SC..t S Ir`►t.,� s �c�� C-'TA'46-' 1 4:Erc.,,i lrl t;�� LAS-K"�:4 S*(fJ 6T L1E2g _. CONSTRUCTION INFORMATION: Additional work to be perrormed under t is permit-c ec a tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors Electric _Plumbing _Sprinklers _Generator Roof Total Sq. Ft of Construction: S060 Sq. Ft. of First Floor: Cost of Construction:$ fc P O00- Utilities: Sewer _Septic Building Height: OWNER/!E�S�SI CONTR CTOR: Name C-!�,j5LA !'oc nit Name: 6+sidK1�.�iLa-rte Address:-3S4 €zC�c-� l� �iijt�% �r`J Company: � Siia.N�41�e��t:�t-' L� City:_Ti aan State:il, Address:.32�Z1 Q L t---A..%i'D272 h,4Q4F_ _ Zip Code:3CM E(SJ Fax: City: fT Ac--_04'e- State:e- Phone No. 77'?_ 86l —7219 Zip Code:�rk(e?I"?Z Fax:'/7Z-Lli t-61ge"— E-Mail: Phone No 1 Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License 6!C[;O53 `7��� If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. St1PPLEMEN +l.CO S RUCTIONN LA I'N'FQRMATI 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 ins on. If you intend to obtain financing, consult wit Jror an attorney before commencing w9K ore in our Notice of Commencement. Signature of essee/Agent Signature ctor/Lice STATE OF FLORIDA STATE OF FLORIQ�Ay ` �,` COUNTY OF S�. Ly c�� COUNTY OF 55 The forgoing instrument was acknowledged before me The forgoing instrument was acknowledge before me this 1 day of �lT\ ,20A6 by this A_�_day of (A by S�cy�ri Ca.SA0V" k)g 14�1AreJey1 (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pu lic-State of Florida) (Signature of Notary Pub'c-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced IdentatronType of ProducedIdentification�t Type of�No,F�o<�0�6�ProduceIdentificationdUL � o e c' est 05a� �` Commission No. Moto {p I �8 o�aty soy Commission No: �S��� '�(SeaQo\' rQ�� �� ` � comm E ps � • ,� te vi?`;��,,, N, G°�.to�s`'` �,�• * � 'o` dint r : f .... REVIEWS FRONT"), , ��Z�O�,,.1�� ��`'s•AS PLANS VEGETATI, --S TLE MANGROVE COUNTER\�;,,J;, / REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.