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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED N© I fl� Date: � hPermit Number: aq� . RECEIVE -1 y, Building Permit Application APR 2 1 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 PERMIT APPLICATION FOR: I PROPOSED INP-ROUEMENi'LOCATION: / l / Address: 7�0 �' �c% lY T G� ,�►^ �u rLd V.11/ Legal Description: Property Tax II#: // & U75" "0 0(90. 0 Lot No. Site Plan Name: /�7`CG/ Block No. Project Name Setbacks F font Back: Right Side: Left Side: DETAILED DE�SCRI�PTION OF WORK: INNOWS-ITIR'UC (ON INFORMATION: Additional work to be performed under this permit-c ec a tat appy: Mechanical —Gas Tank —Gas Piping YShutters —Windows/Doors Electric —Plumbing —Sprinklers _ ',Generator Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: f va Cost of Construction:$ 6L-P Utilities: —Sewer —Septic Building Height: OWNER/LE.SiRCONTRACTOR: Name ✓`o a Name: 1—/1 a'ly7ov �,� dT C Address: n�0. ce,yiG+^'G'✓ Company: City: rV State:Fl Address: SA31,0 cf` , LuGrL d� Zip Code: ,i 11'! Y5' Fax: City: 171. SCC State: Phone No. , 08 -J 2 Zip Code: J 1!PY Fax: '77 E-Mail: I ,I p Phone No 7;.g Fill in fee simple Title Holder on next page (if different E-Mail M, cf/�v d e from the Oi ner listed above) State or County License SGC! 3//E15-0F if value of corjstruction is 2500 or more,a RECORDED Notice of Commencement is required. =MRPLEM, ENTAL C© ISTRWAoTMI N LIEN LAUV INoFORMATiO.N: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable N a m e:_Sgw Ja920 17 A/u �eA ✓7je Al Name: Address © eG�,c..r�✓c vv� Address: 41 City: G c� tate: City: State: Zip: 3 y�kSo Phone 77.;�-oz 6 2-Z 3?f 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. s Signature of Own r/Lessee/Agent } Signature of Contractor icense Holder Wt��.N Woo m STATE OF FLORIDA g STATE OF FLORIDA =LLN COUNTY OF z a COUNTY OF =Z a A 2 The forgoing instrupment was,acknowledgedj�efor r r? The fo going instr en was acknowledged befor VOW this o�/ day of 20/ by a � this / day of 20�� by X >w a m Ki 'a. :� mall ISk t C =ate..oyo: (Name of person acknowledging) '�H...• (Name of person acknowledging) •• '4 f� •,r„,fit•' (Signature of N ry Public-State of FloridW) (Signature?Notao Public-State of Florida Personally Known e-'� 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 SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /2014