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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: ' Permit Number: iE l-1 v �.� MAY 2 7 2096 Building Permit Application PERMITTING Planning and Development Services St. Lucie County, FL 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: .ryNY, s a 3-, C " � - x ` ( .7. ,-a�#�.-, F ;zt l �c°•, ,s�g'ue, `ax f a -ct-'i �� '&r '"�'; PROPOSED ! PROUEM iLQCATt©N. /��s�T ® Address: 72 Z S. /�C>�vl-tP //� / ��. ��c cc's .3 Legal YS— Legal Description: 71-41- P-1-14-de- 1-cle.5 14 {t� D ��� ® � A �2 Property Tax ID#: 0-41— _TZ 3 – ®O 0 b® Lot No. '-0 Site Plan Name: Block No. _Project Name: 5AIda / dfl"_5 Setbacks Front Back:�Right Side: �� LeftSide: X41 F ~mak 'i. !4+.. .r. _ e., z F -t �_ a a d+" ,'. e. a. a> ±" �, d r 43 r � '.,Y'• < ��tCvr � s� ea �r� �'�✓I//.�c ey C / OSE�c�.�ca` C�UC�t7Sc Wc�.�ec� CSV.)S gas u p a huy � +3�.9 4c�,I 44 #d �� Additional work to be pertormed under this permit-check a tat r: appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors �lectric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: /01V� Sq. Ft. of First Floor: Cost of Construction:$ 0� �'� Utilities: —Sewer _Septic Building Height: .LA Nhr� .« ?rtY� � .;*'•t sk^ ,a.*a u^ R �raN '; c now " "- 's" r 4ag i.. ; QWNERjLE�SEE * a T C{3NTR CTOR= 4 . =7r" :d; - F'• 'b w �.x;em�n„ -F' ?a53,id?�t�z, 'N" �a� mc,,.a '%.^h'Sf_.k2 -�,.z�n"k:iF.'s ^'� 'rr`�r � �.,is ar Fir' .�.4.�r.7�,� di4 Name le _57/t/6 A,) / Name: ')N n t'� Address: av'zi / PO( Company: City: f1 7– t0ine,-efe State:%G Address: Zip Code:3Y'!Ol y.Y— Fax: City: State: Phone No.77Z 9 7-9 l Zip Code: Fax: E-Mail:_Sf+✓Ai-O R'&d 4E1 /��"f� • OL 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. � J ,���144'0.b r �`'yIw.. It' e UCF r iw44 3 ` SUP `��ME UTA fQ STft I()hl L'� AV 1 yIF{ E rRI v NINO 5 r � rxr � rid.° krer kr 'mr 4� T Jm # r, �. t „#tot .x,. . DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: I . 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 thepermit 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. Signa ut re of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIP STATE OF FLORIDA COUNTY OF 0,�ij COUNTY OF The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day ofIfs ON 201 by this day of 20_ by a�L_''� �_Om 11 (Name of person acknowledgi (Name of person acknowledging) (Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifica ion Type of Identification ProducedProduced Commission No. W;wY' al) KAREN S. N I E ami ion No. (Seal) s Commission# FF 15637 My Commission Expires „�F �,•` June 12; 2018 REVIEWS FRONT Z fly x VEGETATION _ SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014 i