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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLq INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I Permit Number: (� f: --- - - - 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 — e— PERMIT APPLICATION FOR: PR�©PDSED INPR�OVEMENT LOCATIO • Address: 9aZ4 6NL, AVE 7- 3 4c Legal Description: /,9 .e L CL Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name:_Br�,=bh a Setbacks Front Back: Right Side: Left Side: QETAILED DESCRIPTION lJF V1/ORK: 0 LEW , / n Y r fie, 7 C®NSTRUCTI N I INFORMATION: Additional work to be pertormed under this permit-check all that appy: `Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First-Floor: Cost of Construction:$ Utilities: —Sewer _Septic Building Height: NER/LEWSSEE: CONTRACTOR: Na r.�f. , 1 f� / Name: 7r ',L ,address: -:�.<fi:K;N:n:�.a •.>r� Ave- Company: °'Ci y P111P�f�7r 7Le-4e- State: 7--/ Address: /c-Fcl' 9,UJ c..e0' Zip Code: 3 411S' Fax: City: Ag-- !f': State: Phone No. Zip Code: Fax: E-Mail: Phone No(//713!/2- q713 Fill in fee simple Title Holder on next page(if different E-Mail 6?f'Q a• e from the Owner listed above) State or County License if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SI PP�I_RM10NT�,I I.CQNS�TRl1CTl� I.IEyN L.AUV I'N yORMATIQN.: PP MORTGAGE COMPANY: _N DESIGNER ENGINEER: Not A licable of 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 recordin our Notice of Commencement. Signature of O r Lesse A nt Signatur Con ractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ��— �U��� COUNTY OF S �fc. The forgoing instrument was acknowledged before me The forgoing instrumentas acknowledged before me this�day of 20 ( � by this�day of 20 10 by aOSL �il� (Name of person ackno dgin ) (Name of person acknN;ig(Signature of Notary Public- of Florida ) (Signature of Notary ate of Florida ) Personally Known P educed Personally Known "' "' JOSE FRESNIEUY`-- ,r, o, Notary Public-State o or a Type of Identification •`'��"�' �''•y Type of Identification �*+P s Notary Produced * »'= Commission#FF 184850 produced s Y Public-State of Flodit ",, o m.Expires Dec 22,2018 s ommiss(on a FF 184850 ` o- M mm Expires Dec 22,201 ��• � � ''`�Boidedthrou hNationalNotaryAssn. `�� �� �., Y p Commission No. Commission No. , a, ����,� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.