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HomeMy WebLinkAboutBuilding Permit Application J I . All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED - Date: l0• �r tP • Permit Number: l60 to. 0 p 32 RECEIVED Building Permit Application Planning and Development Services JUN 0 2 1016 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (7721 462-1553 Fax: (772)462-1578 Commercial Residential I PERMIT APPLICATION FOR: - KFOPQSELI INPROVEME T LC�3CATIQN: _ 'n Address-. 1!L4 100 Su,o Set 1R-,o(- _e.U� - -- - - Legal Description:�=`br1S�,1C�(1 �Ve-( SS S ' ltM1 01- �( K. Lot -V CfY1Pr6' --aA-41oa,N) Lor- C��SS -l�f(�� - Iic05- 1033" 1CR Property Tax IID#: a to(-DlaC) 10 9 000 Lot.No. Site Plan Name: Block No. Project Name: r_ I�e V1C e- ('oD.Ir Setbacks front Back: a,rj Right Side:��Left Side: DfTAILf© DnCRIPTt®N ancJ e e me,­i T--e n Ce' .+o ee ►r e nc e- I CQISTR�UCTI�N J11'11111lt; Additional Work to b rmed under this permit-c ec a that-Apply: _Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors Electric _Plumbing —Sprinklers ` Generator , Roof TotalSq. Ft I f Construction: �- q. di �(p I' S Ft -of,, Floor: DV ' Cost of Construction:$ �f);��O Utilities: —Sewer _Septic Building Height: 01NNER/LESSEE: GQ',NIRACT'G�R: Name e- to P Name: 5 �, Address: H" c✓t c,( Company: City: Stater Address: Zip Coder Fax: City: State: Phone No' 7 (09 S Zip Code: Fax: E-Mail: �J,' ���1 ® be(I -4,oL n 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. SIJPPLENIEN SAL CONSTRUCTION IE LAW I�N�F®RMATIO DESIGNER/ENGINEER: _ of Applicable MORTGAGE COMPANY: Not'Applicable Name: Name:SELz�"���f '�liyra�iuncC. Address: Address: I=0. -?pd-4 (nom City: State: City:5 iC1 t L-.(Vy,-e— c,, State: UT- Zip: tZip: Phone Zip:S 11,S Phone: 2d b-a52- S(per FEE SIMPLE TITLE HOLDER: _41ot 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. :ji5U__Fewf O r/Lessee/Contractor as Agent f Signature of Contractor/License Holder STATE OF FLORIDA = STATE OF FLORIDA COUNTY OF COUNTY OF m The forgoing ins e t was a knowledge befor s The forgoing instrument was acknowledged before me this day or.4 04 20 by 2 9O this day of 20_ by MK Cn(Name of person acknowledging) g� (Name of person acknowledging) 4-M Q"'h4g- -'J(Signature of Nry Public-State of Florida (Signature of Notary Public-State of Florida) Personally wn OR Produced Identification Personally Known OR Produced Identification Type of Identifi t' n n Type of Identification Produced Produced Commission (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.