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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED c / Date: 1p '�rl - Permit Number:�(� � ' RECEIVED �C��, .9il#inq Permit Application - JUIN 14 2016 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:$ 'D .r PROPOSE® NPROAVE�(VIE�NT @0CA1'IdN ' Address: M' 1 6 a 5 5o l AZ Due— f o ri. S'T'_ Lac.--e— �y�tS3 Legal Description: fo,i"VI" i k ra e- O C? Property Tax ID#: �/ T �� / "d © ��Z Lot No. Site Plan Name: Block No. Project Name: Ve_rcrn;c.CL te(e'L Setbacks Front Back: Right Side:, Left Side: DETAILED DESRkIPTIONFPM C®i�S�TR(JCTI®N INF®RMATION.: Additional work to be pertormed under this permit-check all.that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof s Total Sq. Ft of Construction: Sq.'Ft. of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic Building Height: OUVNERLESSEE CONTRA AOR: Name Is VeIII-Cl Pere-7- Name: a� Address: 016 0 5�-' som?- I'a-­ Company: i L 6A!5 •C- A City: 11 Pelf-r '51 Lac a State: As Addresses: 3 W;-- Lm15VX Zip Code: f q q f3 Fax: City:PoCA-0 LueAl'k- State: .F(—'(— Phone No. Vim " U� '3g�' Zip Code: q LC3 cF�ax: E-Mail: W iP�ejeZG r, a Aah.90 . Gr))nq Phone No 2.'5`.2-A- /-��� Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License CC If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S11��� LENIEN� ►L C®NSl'R1CTI�N LI' N UIl IN'FORMATIOIU: 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: 7. 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 c•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 len er or an attorney before commencing work or recording our Notice of Commencement. r P 4�1 Y5"a"fu� =wrre Lessee ontractor as Agent for Owner gnat of Contrac or ense Holder *,. STATE OF FLORID STATE OF FLORID "A_ COUNTY OF `. - COUNTY OF '� The for oinginstr m .t was acknowledged befor The for�oing instrument was acknowledged before me this day o 20�by oQ I this 1Uday of 20 IU by T)"F,Y-1 co W (Name of person acknowledging) (Name of person acknowledging A H (Signature otary Public-State o lorida) (Signature of Notary blic-State off lorida) Personally Known OR Produced Identification '/ Personally Known k-""' OR Produced Identification Type of Identifica ' n Type of Identification Produced r� - Produced NTA E.MIR; DA MY COM[USSION#MI9651 Commission No. (Seal) Commission No. 25,2019 Y REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 4