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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: t7 Permit Number: RECEI`'rD APR 14 206 Building Permit Application Planning and DevelopmentServices Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line �n�du� Qao c3 PR®POS E/0 I00001/EMEfi1T LOCATmON _ Address: Ocirina �,� �Drf C,C-ce FL Legal Description: -7©/ - D/y/ , QOQZ2 CorAl Cove 5_04.1. .f4eC?LJ/;a I LaP 16'15' n p Property Tax ID#: O a 5"", 1 "" 6 a O Lot No. aL4 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DEl-AILED DESCRIPTION OF UV.ORK.;;; .,. - _ Ree, I4ce CO>ndowS : -,c Doo t"S o/ S'i z e PG i c�,`� G,��r'� (�6� �`,��►�,i,s C 3� S1I a�V%9 31gss doo�S vr� 9 CQNST,R`UCTIN IR9FORNI00N Additional work toe nertormed un ert is permit-.c ec a appy: DIIHVAC Gas Tank ❑Gas Piping _Shutters L!nd Windows/Doors Electric Plumbing Sprinklers El Generator Roof Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$ /8000,pO Utilities. ElSeptic Building Height: O�II/NER/LESSEE � - CONTRACTOR Name i ( Name: Address: 3 , 0 I'►+ lJ / Ave Company: i )q/�kin.,, PAIN City: )C;- State: d�`1 Address: 2 14ve Zip Code: 3 Fax: City: Ca)Q. Stater Phone No. 26-3- !L// - J S' � Zip Code: 33,&Jr2 Fax: E-Mail: Phone No. , 10.3- �/ N -I Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: If Value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: �i Not Applicable MORTGAGE COMPANY: X Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: V 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 thepermit 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. _Signature of Owner/Lessee/Agent Sign ture of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA , COUNTY OF 5�. LCOUNTY OF 1--0c The forgoing instrument was acknowledged efore me The forgoing instrument was acknowledged before me this a day of 4 Q P 20 !�by this�day of p t�. ,20 -by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) s D\VEN F\onda .. , Personally Known OR Pro ucic �I�ft4 ti6 Personally Known iced Id on Type of Identification P,r,'. �1, \\c" DecrType of Identificati P�4 ed L W Florida ,•`Y-PUB" x ' G SO• r+ `,,�pBY PLe�i'' Notary 16,201 �—�&.r =.My�0mm. on No�arV a� s Comm.�7Y ices Dec Commission No. ��.�_ - Go( �� ho�ai+ona\F,� Commission No. ;My miss� �4I�E 858761 •`, ational Notary JF«��`` ?oncod�nrough N �; �. Revised 07/15/2014'' REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS