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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r I , Date: 6/21/2016 Permit Number: 10 Oco "7 M 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 X PERMIT APPLICATION FOR: Plumbing El PfP POSED J 1P�—ROVEMENT �;OCA�"10N. Address: 203 Easy Street Legal Description: Lot 10 Block 14 Unit 3 Indian River Estates Property Tax ID#: 3402-604-0010-000-0 Lot No.10 Site Plan Name: Block No. 14 Project Name: Setbacks Front Back: Right Side: Left Side: _ DETAILED DESCRIPTION-OF WORK; Municipal Water Hook-up Adcl�1�IST'RUC"fI�N`I`NFORMATIOIU 1 itiona wor to e e orme under t is permit—cheCK all appy: HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors OElectric Plumbing O Sprinklers Generator Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 585.00 Utilities: Sewer E]Septic Building Height: Cfl NE i L� CONTRA Name Elena Cucciarre Name: City of Port St Lucie Address: 125 Holland Ave Company: Utilities System Dept City: White Plains State:NY Address: 900 Se Ogden Ln Zip Code: 10603 Fax: City: Port St Lucie State:FL Phone No.(914)396-2651 Zip Code: 34983 Fax: E-Mail: Phone No. (772)873-6400 Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: 25597 if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 1 11 1 SW' TA� l�l �l ��lV LIEN LAW !NFORMATiON� � 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: 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 com ork o7fiRcordi.ng your Notice of Commencement. s _Signature of ner/Lessee/Agent Signature of Contractor/License Holder STATE OF FL IDA STATE OF FLORIDA COUNTY OF S1. Lu.ui, COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 1�day of ILy 20 L6-by this day of 120 by 1 L rad H rg (Name of person acknowledging) (Name of person acknowledging) Q�&.tr' �I"'n' (Sign V re of Notary Public-Sta of Florida ) (Signature of Notary Public-State of Florida ) Personally Known_l OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced JEANEITE Commission No. ARYPUBLIC Commission No. (Seal) STATE OF FLORIDA LW- -Cornm#EE843255 Expires 10/1412016 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS