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HomeMy WebLinkAboutBuilding Permit Application rcillntivurnoer: .��� r' EQEIAPR -18 2016 Building Permit_Application t - Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce F!34982 A/1 - Phone:(772).462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR. PRC*?PQSBIN,NP iO;U�EMENT &CATI© Address: �� t�5im uoc,)6 n^ejrcG Legal'Descriptiori: cic.,e- Iu z 1 KJ -� -F ctt Gds Z: �- N 5 8k 141m Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: QETAILED � C ISP I(JN @P W=; MID K CONSTRUC 10 NF�RMAT QN: �tional work to be perrormed under this permit-cneck all tat appy: —Mechanical _,Gas Tank —Gas Piping �Shutters Windows/Doors Electric . Plumbing Sprinklers r Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: o Cost of Construction:$ b 4.d Utilities: Sewer ' i Septic Building Height: OWNER LESM CtJNTRACTOR: Name �Y67�✓1t"_,tsCo ��� �e-r�� Name: Address: 6,590 oi?Pme, Company: City: t&n�;i State: Address; r Zip Code:J5V& Fax: L56 t --S 75r-7525( City: State: Phone No. '59/- Zip Code: Fax: E-Mail:12mc., 'j-oS, Ttkuj.Coo-7 Phone No 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 2560 or more,a RECORDED Notice of Commencement is required. D 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 Commencement. Signature of ner/Lessee/Contractor as Agent far Owner Signature of Contractor/License Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF k-•V C~1 COUNTY OF The fcEgoing instrument was acknowledg�e�l before me The forgoing instrument was acknowledged before me this day of �1 20_ by this .day of ,20^ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary P lic-State of Florida} (Signature of Notary Public-State of Florida} Personally Known OR Produced IdgD1ifigg � Personally Known OR Produced Identification Type of Identification oEPNNA State°t F\0` 6 Type of Identification Produced L �1 1. , pUb\ic" e�1b• Produced 'y�O"c�� Fltf�s' m.EXp\tes��856161 Commission No. Commission No. (Seal) f,0 6°n0 ",vow vow REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED e . 77/2014a