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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ` / Permit Number: i o � � a is RECEIVED Building Permit Application Planning and Development Services JUN 2016 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential C PERM ITA PLICATION FOR: (Arr I C-A v?-e— S�iu �ers P OPOSED INPR4UEMEN1T_LOCATIO,N: Address: (� �L Or F+• i 2Y^G2 R 3qqSl Legal Description: 1 diG2J f �eS �/!J - T ��CtS� 2-Lo4 f� 01h (345)CoP_ Property Tax ID#: 3 J Z/-�j Lot No. C' Site Plan Name: t lh Y_ Vi a Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DES'CR§iPTION ©'F WOR+K• f' . ... � � Srt 1,l,H-•T r �d� U(= � r^�� �c Yie � � rS I : ► X z��� (41__Gz? ir cel 01--) ,S J-) rs CONSSTRUCTION NFORMATION: 'Additional wor tobepertormed under tispermit-c ec all that appy: _Mechanical _Gas Tank _Gas PipingShutters _Windows/Doors Electric _Plumbing _Sprinklers -Generator _Roof Totdl"Sq''Ft ofConstruction: u Sq. Ft. of First Floor: Cost of Construction:$ to ,�'/ / Utilities: —Sewer —Septic Building Height: OWN EN Name C®NTRACTQR: Name r�SS( a,YY1 Cc.Via Name: lvli r'l 4yk7 vaJq S See Address: 73, (-,,,OZ &; Q_ DY-. Company: �•V'T } �rr-i cavi s City: 1. q<ey-c 2._ State: Address: 00 Zip Code:` q '5-) s� ) Fax: City: t r• ( e y-C.Q State: Phone No. ?72— �$ - '93 Zip Code: 3`f 0)5 Fax: -7 q�--1-5lb E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail u. from the Owner listed above) State or County License 42 10 Fly If value of consti uction is 2500 or more,a RECORDED Notice of Commencement is required. S�l1PPLENIENTAL COO NSTR,tJ'CTI®N LIEN L�1UV 01 NON 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 commenc,kng work or recording our Notice of Commencement. yli�- L/, ��, J - 11 L�T6t,_5j Signature of Owner/Lessee/Agent Signature o Contractor/License Holder 77RV; STATE OF FLORID STATE OF FLORIDA W COUNTY OF COUNTY OF - LLQ LL The forgoing instr ent was acknowledged before 4 o z The forgoing instr ent was cknowledgepefore m m 55m z this day of 20/& by W Lw Z this day of 20/Iby ¢ZE¢ 2 CC� a oa FUIL ¢�W Ili �Wm / HISS Name of person acknowledging) Name of person acknowledging (Signature oftary Pu ic-State of4florida (Signature of Notar' ulic bb b -State of Florida Personally Known /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. /2014