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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �C� Permit Number: 00�-0 RECER' D MAY 24 2016 s 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: PROPOSED IMLPs R©VEMENT L®CATION: l J_e Address: '/07 1 f OG�� 9,^ *,7/G r7Seh ge4e- /c/• 3yyJ`7 Legal Description: Ve✓ &,e Out 4 f Property Tax ID#: /V F// - 5_162- 0 0Lot No. J/O/ Site Plan Name: Veo/Lire Block No. Project Name: y ff1d Setbacks Front Back: Right Side: Left Side: w CQm�/eke derma%��%oma �T��/ re�aov-�/ Of tvo/%/ flame (Xor' a d'.pvn" CONSTRUCTION 1R+MA Nis M Additional work to be erformed under this permit-check all appy: HVAC Gas Tank E]Gas Piping Shutters I]Windows/Doors Electric ❑_Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: Z. O Sq. Ft.of First Floor: ld'7 Cost of Construction:$ 700 oo Utilities: Sewer 11 Septic Building Height: BICT• 011lN E R/LEASSf E': C_O,NTRAOiR; Namei4✓ne 5 6. Peelb ?Pk L,--1 /6 Name: .� � 1► Com an y s� . . p: City _f��»y .'. 11� nC State: TX Address. 4'e I, Zip'Coder :7?�l�'7+J_.... Fax: City:.`�e�Sin ' %��u��. State:14• Phone Nd.-,'`":" 7 V.2 92 Zip Code: :3% 'Jr7 Fax: ZZZ 7-32 21'7/ E-Mail: Phone No. 7�2 Zd0 37/!j Fill in fee simple Title Holder on next page(if different E-Mail: inc 0/4100 .Cool from the Owner listed above) State or County License: CRR /1Z6-1947/ If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Sl1'PRLEMENTAL COI ISR+l1C:Tl®N N I iENI hAW I�NIF®R+MATI®N: 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: 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 wpck o ecording yaur_Nbtice of Commencement.' S 15�54 Z4_���k _Signature of Owner/Lessee/Agent Signature of Contractor/ icense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF drf'M COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this a3`1day of Me( 20 Eby this 33,L day of /''lay 20 16 by 1 A a m s on A N', .Sm (Name of person acknq�wledging) (Name of person a knowledging) (Sign re of Notary Public-St a of Florida) (Si ature of Notary Pub' /-State of Florida Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced i=L Type of Identification Produced FL 1�✓t 5 LAY s� Commission No. FOHS335 t -I anChris"herPAIler Pr'740-5)5 Sea�ylanChdatopherWier t ea Commission No. N TARY PUBLIC _STATE OF FLORIDA NOTARY PUBLIC STATE np FLORIDA Revised 07/15/2014 �s✓NCE 1e% Expires 1/6/2020 ,;s✓ , =Cantu#FF948335 NCE 19 a Expires 1/6/2020 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS