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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � a� � Permit Number: RECEN'D JUN 24 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 PERMIT APPLICATION FOR: Address: S+c, s' IQ3,V z Legal Description: Property Tax ID#: ����" O�'08�1 'd08– � Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAfLED D'E�SCR�I�PTI®'N QF W®RK: CONSTRIJC�TIQN 1:N'F®Rrl1/IATIQN: Additional wor to6eperformed 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: Sq. Ft. of First Floor: Cost of Construction:$ N3b® . CS(5 Utilities: _Se Namec� M+, C, � Name: Address: a V 1z_ Compan W• ' City: �c�r • State: Address: Z/IV SW ST" Zip Coder�`� Fax: City:-wt" 4Y!;0 �L CJ State: Phone No. S O © Zip Code: �9 g [� Fax: E-Mail: Phone No -777, – c2 O/ 41 Fill in fee simple Title Holder on next page(if different E-Mail '/ 611,"1 _d Tom: fe C�srq from the Owner listed above) State or County License G&C- V 1573.E If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. �tJ'PPL.E11/IEN L CaNST CTI'UN EN 1r4U11 IN QRf1/1�4TIQ / — PP MORTGAGE COMPANY: _Not Applicable DESIGNER ENGINEER: ARPP licable 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 attorn y before commencing work or recording our Notice of Commencement. 71 Sig re of Owner/Lessee/Contract �-nat'ure s Agent for Owner o ontractor ucens older STATE OF FLORIDA Y STATE OF FLORIDA, COUNTY OF (,((► i Re— COUNTY OF _.. �• The forgoing instr ment was acknowledged before me The forg. i t nt s aj cnowledgedd this�rday of 20//�q by this of by e SS 1 nal.J em_zz (Name of person acknowledging) (Plame of person acknowledging) (Sign(ure of No aryPub c-State of Florida").. nat e o otary Public-State of Florida) Personally oOPAW1►QJs11111111id6NE11ficati Person--�R �I� Identification Type of Ide i �� No rE P41ft-Safe of Flodds Type o -} ration Y T 8L � Produced o t . f5;2018 Produ MY COMMISSIont F;2�27i6 '•.,N „r mlei on E f108 ,o.,.;,• EXPIRES June 08,2049 Commissio 441 a 990 lop Com FlondiNO.a ., ico.con• (S al) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014