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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INYO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: y 2 Permit Number: go I 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: PROPOSED INPRC#VEMENT LO:GATIC g Address: � `7T M 'A� 1©40.2 — Legal Description: ,,� Property Tax ID#: 5"C�4-6-r- Lot No. "Site Plan Name: 1 ��✓ ��� (�ti.� �c'� Block No. Project Name: Setbacks Front Back: Right Side: Left Side: I DETAILED DESCRIPTION OaF PLO- "L s G� tfe,\I�A !"k-01A J�� o "!> i i z CONSTRUCTION INFORMATION '; Additional work to be performed under this permit—check all that app y j _Mechanical _Gas Tank _Gas Piping —Shutters i eindows/Doors _Electric _Plumbing _Sprinklers _Generator 'i —Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic I Building Height: OW;.NELESCONTRAC 'OR` �` Name Address: Company; " CitStateA& Address Cs— Zip CodeL!&t?,3�'7 Fax: City: State: Phone No. t �3�'(Sn?"D� '� © Zip Code: Fax:777, ZX3- 19i E-Mail: Phone No 77Z- Z83 /5N,�? Fill in fee simple Title Holder on next page(if different E-Mail f�._�Y`T ,60,6 74 /40L.•C;::,/YJ 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 CONSTRI glQN Ll E' 1AUV IIV ORMATION 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 Commen ent. Signature of Owner/Lessee/A e t Sig re of Contractor/License Holder STATE OF FLORIDA �3 / STATE OF FLORIDA COUNTY OF d7�zoey COUNTY OF Z?�At4 The forgoing instru ent was acknowledged¢efore me The fo oing instru ent was acknowledged before me this day of 20I by this May of In 4- 20,/Aby (Name of person acknowled ng) (Name ern ac ledging) � Q ign ture of NotjryPublicd-StateofF1jonda) , irida) (Si natu a of Notary Public-State of Florida) Personally Known i ersonally Known OR Produced Identification Type of IdentificatbliicStateof Florida Type of Identification Produced erSharath Produced Nota Public State of Florida ission FF 982709 Lisa Greer Bharath Commission No. 2/ Commission No. oFq; Mxpy reso �9827os REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014