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HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: � ' I 25; • : RECEIVED _ Building Permit Application APR 19 2016 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 I . PERMIT APPLICATION FOR: c e . EIU IENI" L®CAl'I®N;:_ n r , k PR®POSED IIN'PR©�U� T Address: u se III- r-f-aw Cot 2cr Legal Description:."- V6V4�.L DE WOOP ICI a L, `M I _ w LTp� � v / p� /� IJ� J � %� ® ® � Lot No. Property Tax ID#: � r Site Plan Name: Block No.� Project Name: f Vk- Setbacks Firont Back: Right Side: Left Side: DETAI'IED DE=ASCRIPTION WORK: :,. III . / (:Z— VOTM X1'1 GJ C®NSTRdUCT ION ffifff®'R,MAT' ®N: WAIM Additional-W tiona-war to a per orme under this permit-check all that appy:; _MechalI ical _Gas Tank _Gas Piping Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total.Sq.-Ft of.Construction: Sq. Ft. of Firstfloor: Cost'of Construction:$ Utilities: -Sewer­ _Septic Building Height: OUIINER/LESS CON RACI"OR: Name II.. /) Name: Address: Company:A! J5�1)C - C0417J2�4A2q City: State:V Address:'JbS N UC & TL--(Z- Zip Code: I`J�-{ G? 3 Fax: City: PSS 1 Lr � State Phone No. 'T7Z �6�()-'3 Zip Code: BLRc+J Fax: E-Mail: I Phone No D3 Fill in fee s mpie Title Holder on next page.( if different E-Mail from the Owner fisted above) State or County License If value of coi struction is 2500 or more,a RECORDED Notice of Commencement is required. SSU PLE'I1iIENTAtCON�STR.l7f�TC®IU LEEN IOWI`[V;-@,R+{1/f�1TI®N; DESIGNER ,NGINEER: _ Not Applicable MORTGAGE COMPANY: OMPANY: _ 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 Commenceme t. V110 AN — /�� & ignature of Owner/Lessee/Contractor as Agent for Owner Signature.of Contra c /License Holder STATE OF FLORIDA STATE OF FLORID COUNTY OF ' "*'�- COUNTY OFati'�`" The f oing instr pent was acknowledg d bef r9iiThe f oing instr nt was acknowledged be e this day of 2Q , b this day of 26& b Mii $xTo �c umi�"� ke a mfg r7OrQ �...v, �cn (Name of person acknowledging) V9 (Name of person acknowledging) w 2 z a Nv mS C_ �T_m9 (Signature of N Public-State of Flora a) f``lf (Sig ture of Nota ublic-State of Florida) Personally Known' l OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 712014