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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /I-- Date: if�l 1;2 Permit Number: J lD 01 o 12a . _ IVSD _ -- - -- Building Permit Application JUIN ®6 2016 Planning an 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: PR�O�„�P'fJSED I�N�F''R0�/EMENT L©CA�IQN: Address: 111®-7 E'DeAj b i r ��, is-- v'tjQ Legal Description: wrsxn!�t 24RAL l l,u 3 r_cG Z�i tmz t I z ys��') Property Taxi ID#: Z Lot No. Site Plan Narpe: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET'AI�LED QE��CR�1P`TI®N OF WOR+K: ,,`� ��.tnc1% �r-c�ut'rL�� ���'uSax�lJr I �r�)7Q�✓1� �� �r rrLL���L a�n� �u-r �K �,� P ;CA �Q ten.►L. F'i.4— _ , - i CONSTRUCTr®N INFO'R+MATION: :Additional work to be pertormed under this permit—check all that apply- Mechanical ppy:MechInical _.Gas Tank -Gas Piping ,Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator Roof 77- Total Sq. JFt f Construction: fov Sq. Ft. of Fi'rst,Floor: Cost of Construction: $ Utilities: _Sewer _Septic Building Height: OW�NERJLE-�S�SEE: C®NTR�CTO'R: Name��� Name:�_A�'�l�nJ(�tilti�, � P AddCompany: City: r Pr .�` State: Address:_] I 4 ,�- -ori Lcl� Zip Code:l,3`f is=1 Fax: City: fC�=yl,( State:��- Phone No. "Z'?Z �( � �''l Zip Code: 3*QY-2.- Fax: 777— '1& E-Mail: Phone No--n ,—U& &D rF7 Fill in fee simple Title Holder on next page (if different E-Mail j TA � s/�ty , 6J from the Owner listed above) State or County License_G�CGo53`�7 If value of c nstruction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTI®N LIsEN LAW I`NF©RMATIO,N: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: ",,Q Name: — Address: ?ZDV -Lys Civ& Address: City: 12 c(., State:J:J7` City: State: Zip: -itj Phone q(a& T.3;0�— 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 you roperty. A Notice of Commencement must be recorded and posted on the jobsite before the first in ecti ou intend to obtain financing, consult with lender or ney before commencing r cordir11g your Notice of Commencement. Signaturef O ee/Contractor as Agent Signature o ontrac STATE OF FLORIDA = STATE OF FLORIDA `°' COUNTY OF ':"s COUNTY OF The for oing ins ent was a nowledged befon �a The for oing ins t was acknowledged before CD �b o this day of 20�by 2 Mm 9 this day 20by m�m mT"0 if goV o• I •�T 9 (Name of person acknowledging) z3� oA me of person a c k n o wl edging) �N �p co • • •' (Signature of No ry Public-I I'Fa—te-of Floricli) ( ignature of Vary Pu Iic- tate of FlAricla) Personally Known t_/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 ev. 7/2014