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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIV.1 JUN 15 2016 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 G` PERMIT APPLICATION FOR: POP®SED INPROUEMENT LOCATION: Address: x-77 ��e � �� p,_W Legal Description: Property Tax ID#: (2020 6601 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front 'Back: Right Side: Left Side: DET ILED DE�SC*RIPT © OF ORK: fE �—�'yc l.�c l�Com- I�� � �� �C9- r--tst-z' ei--- VV1 o-p CF teV) —6'�—K,u�vv� CON'S TRUCTIO INFORMATION: Additionalwork to be pertormed under this permit-check all that appy: _Mechanical _Gas Tank Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator Roof Total Sq. Ft of Construction: xv ' D Sq. Ft.of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic Building Height: OWNS /LE�S�SE : CONT 0 : Name i mAA Y00AC., Name: vac-:y�.i Address: 3(20 (;LV'D Company: City: rt pbey- " State: t"C. Address: Zip Code: 3 49 2— Fax: City: State: CZ J Phone No. .777— R$r-)1,3rS— Zip Code:Ata, E-Mail: Phone No 'T)2,; ?—L(,-0q,-7 q,-7 Fill in fee simple Title Holder on next page(if different E-Mail ` from the Owner listed above) State or County License � �;S'7 / If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 5llP'PLEME"19TAL CONSTRLICTC®N LIEN LAW I`NFORI(UTATIR N: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: lAA\ Ute/ L66+1AQ3 Name: Address: —7-7,oS' Address: City: PSL State: _ City: State: Zip: 3,qS'7 Phone 7"77_ �f �'�'a� 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 ad posted on the jobsite before the first i .ctionou intend to obtain financing, consult with le r or n attorney before commencin rk cee'orcliog your Notice of Commencement. -it nature of Owner Lessee/Contractor as Agent for Owner Signature of Co or License Holder STATE OF FLOIZI�A STATE OF FLO IDA. COUNTY OF - L U C \ COUNTY OF The foping instrument was acknowledged before me The forgoing instrument was acknowledged before me this N t> day of 20_O by this 5 day of �yYt� 20 by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary PAlic-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifications - Type of Identification 'r �. 3_ . Produced r GIVENS DEANNA GIVENS r ANNA Produced d �i• '° `P e?', Notary Public Slate of Roma 2016 ►sem Notary?ublic State of Flo idaf Commission No. �,y Comn(S€ ,les Dec 16, Commission No. L(� `�1 ?I 1 rAy comm(%40s Dec 16,2016 J Commission#EE 958761 Commission#EE 858761 A i y Assn. N : Through t\alional Not ;� „';. oncied Through National Notary Assr,. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014