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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,( Date: Permit Number: �V� 1 ' Lori s _ 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPRgVEMERIT LOCATION F = Address: 510"7 Re_n nv Ln Eoyr• 1�o"c_e- E L 4 9 5 1 Legal Description: Lake-wooA O n+} 8 - 'GLIA 9 3 gat 20 Map i 3�62N) (OR 669-2011 ) Property Tax ID#: 1301 - 6,09-01449 - 000 -9 Lot No. 20 Site Plan Name: Block No. '93 Project Name: (Pgrt R,eyer Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK >; F. " . . Fear -tine- coop , ireviail fie. roog deck 0i (.suer►+ cote. , lrefa;,; d4magccl dry_;n ,,yf 3p$k Telt all e�e� JPIasln n5 and) ilns-�all dl"Meos�onal shivl9fes. CONSTRUCTION INFORM, ATI-OiV - Additional work to be nertormed under this permit—check all at appy: 0HVAC! LJ Gas Tank ❑Gas Piping _Shutters Windows/Doors Electric 0 Plumbing Sprinklers F]Generator ©Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ (�5 12 Utilities:Sewer Septic Building Height: 01NNERLESSEE CONTRACTOR Name i>a-- Re_4 e Name: Daniel so"-ka Address: 25c- 23`` ay. Company: .5orokn �oo�rnq , LLC City: 1 e_ro Bach State: FL Address: P0, Box GS002Co Zip Code: 32962 Fax: City: Jero ?�,-ac[n - State: FL Phone No. 1 5511- 711(,1 (772) Zip Code: 3Z`7(05 Fax: E-Mail: 9 PT@YQa123 d belisou+4►."e1- Phone No. (772,� Z31 -1983 Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: C C C 1 33 00 0 S if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 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,swimmin ools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNINGTO OWNER: r failure to Record a Notice of Commencement may re in your paying twice for improvements to your operty.A Notice of Commencement must be ecord nd posted on the jobsite before the first inspe n. If you intend to obtain financing, consult h len or an attorney before commencin ork or ecordin our Notice of Commencement. s u of VID essee/Agent Si f Cont ctor License Holder STATE OF F.L STATE I FL RIDACOUNTY OFSZ4- COUNTY OF _91 JI'Lr e The forgoing inst ment was acknowledged before me The for oing instr ent was acknowledged before me this day of� 20 by this day of 20 by (Na e'bf person acknowledging) (Name of person acknowledging) 4ignature of Notary Publi -State of Florida) SQ. ignature of Notary Public- to of Florida) Personally Known OR Produced Identification Personallyl:Knowns OR Produced Identification T of Identific�tion Produce, Type of1ldentifica on ro 1 1L f_i 4�a C �—' �Sr�.� M •Q 41 Notary Pu- Commission No. (Seal) Commission N�. (Seal W C omm. - Revised 0 •o�PiiY��°, LASHAHNA INGRAM 7/15/ ¢* .R�: Notary Public-State of Florida ' .•=My Comm.Expires °•' Commission FF 177249 REVIEWS "" OZONMhNati n£blRJAVJ� R PLANS VEGETATION SEATURTLE MANGROVE O N E �7l&'11'' REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS