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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLI INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: •/ Permit Number: fir' d43� RECEI'.' D MM 0 3 2016 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: S�< _s �PR"DP(3SED�IIUaP-RQ�IEMEN� L®��ATIQ„N - �� � Address: 0 3 0 76 5 254h Sr 1:'0 r-f Pie- F L_ 3 q 161 Legal Description: Edge.wooc4 IAC res. 61 K I Lois 2 , 3 � 4 - eSS I) 15-1 I+ Property Tax ID#: �-`{1$' 603— 0002 — 000-Y Lot No. 2 3+ Site Plan Name: E8Je'uJ6od 4cre5 Block No. Project Name: Setbacks Front Back: D Right Side: Left Side: DETAILEDDESCR=IPT�I®'N' 0-F W®RK: Re,�©cc4ia» as ed b q - �,i we red to X" 12. e C®NSTR`IJCTIfNiF®RMATt®�N: Additional work to be performed under this permit—c ec a ;t at.app y: _Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors Electric _Plumbing _Sprinklers Generator _Roof Total Sq. Ft of Construction: 0 Sq.,,Ft. of First Floor: i Cost of Construction: $ 100 Utilities: Sewer _Septic Building Height: ro f: OWNER/LESSE C1ne.K C*�TOR: Name ® C-0hn e, Ghi I& Name: Address:1111111 3016 S• 2-S+h Si Company: City:'# FD r+ f i e-rc a State: EL Address: Zip Code: Q q1& I Fax: City: State: Phone No. a 109 5' Zip Code: Fax: E-Mail: "C'Kilds b Kel ob bell 5ow4A,.,'t_-t• 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 2500 or more,a RECORDED Notice of Commencement is required. SUe"PPLE�NIE'NTAtI.CDNSTR�IJCTC®N LIEN I..�W I�NFO,R11/IgTIQmla r DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: `13�0 /� l3fh IP / Address: City: State =L City: State: Zip: 4 Phone -B 6 - 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. Si nag., tureo0.4vner Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA - STATE OF FLORIDA COUNTY OF e.1- COUNTY OF The forgoing instru gent was acknowledged befo mg g The forgoing instrument was acknowledged before me this day of 20 �W b y �N 9 this day of 20_ by rr a� (Name of person acknowledging) k ¢�W (Name of person acknowledging) gQ 2 U >-W $ 0,1,4 JAA_ 0 m (Signature of N aryPublic- tate of Florida) ;a� `� (Signature of Notary Public-State of Florida) . Personally Known OR Produced Identifi 1 4:TE 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. 4