Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABL'E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: -3s I . ' a RECEIVED Building Permit Application MAY Planning and Development Services2 4 �o�s Building and Code Regulation Division 2300 VirginiaiAvenue, Fort Pierce FL 34982 Phone: (7721)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: I � m�...te P C3PtOSED INPROUEII/If NT�COCATIQN rK a, w,�e.a., ��F. �. . _ . Address:/._l 1 �[7/� R,,CE BLVD Legal Description: a r.1y,9zzn Parc-lAsar 7- 84-k 77-La T/z Property Tax ID#: 130 ©7- D/9(o- omo--0 Lot No. l2 Site Plan Name: Block No.77 Project Name: Setbacks Fi ont Back: Right Side: Left Side: DEA AILECt ESCRI! TIDIY�E7 4157,44-� AF"AeMZF bore 4do ,�CN CAQF� �T rwr-- (/dca-raws 7,i50- tlC4 5r- U1 r- r � . '8���^�` A '.!� `eke CONS= Rt1CTItJIV,INFORMA�TION " il�iw a . a'r� Additional work to be pertormed under this permit-check all that apply: _Mecha ical _Gas Tank _Gas,Piping Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof TotalSq. Ft of-Construction:. Sq. Ft. of"First.Floor:, Cost of Construction:$ Utilities: _Sewer _Septic Building Height: OW' IER/I_ESrJIc ��„Yi ..any k ReRT�fY1,: 4anMAR 4a 3Y � .tr,.,y mega6an , x., .. �. -.amu n Name 6,FIk2WA1,�AP .5AC=F Name: ,P®c� 8E111A E7-T Jho Address: -rzo, i 4eo elAQsc C/R Company:�e®r� �i�KETT IQ ®A6T CO City: T -- -ze State:LC L Address:&Q(t/�7t: �e .4 Zip Code: Fax: City: 0�e? PE'oCt=- Stater Phone No. 772-3�9-393 Zip Code:,3494 Fax: Z22- 5--d$!E? E-Mail: Phone No 7?Z^ 5� -0553, .722--974--A,506 Fill in fee si�npie Title Holder on next page(if different E-Mail neJ 1 77 Ar7- X1ET from the 011i ner listed above) State or County License 699 0 g-ZO9¢. LIf value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SSU;PPLEi�II�ENT�ALeC®NSTRUC�TI®N LEEN LfA�UV IN.FORMATIO.N r — � 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: 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. Sign ture wner/Lessee/Contract Agent for ,,, Sig ature Contractor/License Hol STATE OF FLORIDA > - :i STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before x;� The forgoing instrument was acknowledged before •.... = this'day of 20�&by 9-ME-- thisp�i day of 20�•by 9 i3GC apo /`eti rnT v n 9k 2 mK m (Name of pe son acknowledging) (Name of P(/Son acknowledgingsu) z= �N C �"M NST= Q&A" A..G (Signature of N Vry Public-State of Flori a) (Signature of NoJJyy Public-State of Florida) w N Personally Known /100— 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 Te—v.