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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVED MAY 2 72016 .- 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: PROPfJS//E��,,D INPR,O,V/�EMENT LOCATI0�1: Address: �1 �l� I � ) ,120- 1L�t� �t QN�Q_ �L `S4R QT Legal Description:, ' -[ 71 b —S-bb Property Tax ID#: Lot No. Z) Site Plan Name: Block No. Project Name: �v��r Setbacks Front Back: Right Side: Left Side: DETAILED R=PTION OF WORK: q(D 3D 0 0 V a 1 G � CONSTRUCTIaN INFO � MAT(ON: itiona wor to be performed under this permit—c ec a Itat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roofs " Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:< r - rUtilities: _Sewer _Septic Building Height: OWNER/LE=�S�SEE: CQNTRACTOR: NameName': , Address X10 -f`eh.'� Q� ���7 Co,m an. ' City , R`2;�,rP ;sL �r" State: --Address l Gf2o N.ik-'J�.�,N-Q—"��- Sly e-1 Zip Code: Fax: City: l L` State:_�'L Phone No-z� l»- Zip Code: r! i-{' 2—(s Fax: E-Mail: Phone N ( ' ��i� —Cr5�3cSv Fill in fee simple Title Holder on next page (if different E-Mailr1��1� from the Owner listed above) State or County License 1 '� �a�i 3 U if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S PPLE�MEN C® STRU TI©N � �N LA N`'e RMAT �I�: 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 an attorney before commencingwork or recordingour Notice of Commencement. Signature of Owner/Lessee/Agent ignature of Contractor/Licehse Holder STATE OF FLO �r� � STATE OF FLAAV�A_ COUNTY OF ���� ».+��1� COUNTY OF\�\�',�\\\ g� The for Ang instru ent was acknowledged before me The forgoing instr ment was acknowledged before me this day of 20Z(C, by thisLt day of 20/6n by (Name of person acknowledZof Florid (Name of person acknowledging) � . ()�ry ((-�, /� -_ 12Z&V'*�' ur(Signateof NotaryPubic- a) (Signature of Notary ub -State of Florida) Personally Known_\_�OR Produced Identification Personally Known L�OR Produced Identification Type of Identification Type of Identification Produced Produced ­11141111'. Q... Heather SpearsHeather Spears COMMISSION#FF242393 Commission No. _ meal) EXPIRES:June 21,2019 Commission No. _ _ (S6@MMISSIONOFF242393 WWW,AARONNOTARY.CO = EXPI ES:June 21,2019 4',.` ��.�` www.AARONNOTARY.COM REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.