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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 rJ `� Permit Number: TT 7B JUL 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 PERMIT APPLICATION FOR: PROP®SED I'N"PRO EMENl"LUCATI�� N: Address: ?/" ��®✓�� y S 1l �9 r; 7/ Legal Description: Property Tax ID#: ZZL�� d Sv�2� Lot No. Site Plan Name: Block No. Project Name: 'S Setbacks Front Back: Right Side: Left Side: DETAILED DE�S�R�I /TON Of 0'R+K: /� /� J i CONSTRUCTI�INS IN -®R+ AT10 Additional work to be performed under this permit–check all that app y: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft.of Construction: 7,Z C�1 Sq. Ft.of First Floor: Cost of Construction:$ ,/SCJ O Utilities: —Sewer —Septic Building Height: 0 NER/LE�S�SECONTRACTOR: NameAiL1�0� 15 4 're0 Name: Address: 3OF se— 4drs2s�� �s�, f3L� Company: 2=�--- - City: e - L State: ,C— Address: Zip Code: Fax: City: C State: Phone No. 77 Z——'�7 e> Zip Code: SJ Z Fax: E-Mail: Phone No © v Fill in fee simple Title Holder on next page(if different E-Mail /f/U from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL C«ONSTR�tJCTIQN LIEN LAW INFCIRMATI®N: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _N'ot 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 attorney before commencing work or recording our Notice of Commencement. nature of Owner/L e/C tractor as Agent for Owner ignature of Contracto i e Holder STATE OF FLORIDA STATE OF FLORI A COUNTY OF SeT Ly� COUNTY OF S k • �— The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this `J day of �5 yL�=20) by this \S day of 20_E by (Name of persona nowledging) (Name of person acknowledging) (Signature of Notary Pu c-State of Florida) (Signature of Notary ublic-State of Florida) Personally Known 0�R Produce � �ttiti�i�a i51? �R ti Personally Known QS 1?roduced!den iFN L� � Type of Identifi atloh `�Y Pie! Notary Public Stake 16,2016 Type of IdentifVtion 4 ,Y pie` DEA H ". Notary Public Sate o Fl_201 Produced �`� `�= Expires s1 Produced L- �`u 2016 _ EE 8587 ,,.�. m.Expires Dec 16, mission `' 71a ronat Notary A$5 r� 'o Go in #EE 858761 Commission No. �t a F cl gondedI('('Se's) Commission NO. Bonded ihi l�lalional No Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Plannin6&DevelopmentSer4ices ASBESTOS NOTICE Buildfng&Code Regulation Divislon_ 2306 Virginia Avenue. Fort Pierce,FL.34982,.. Phone:(772)46241h Fax:(772)46_2-6443 L E COPY Asbestos Notice to Contractor July 15, 2016 GALE FORCE HURRICANE SHUTTER INC ALTINO ROBERT 1429 SE VILLAGE GREEN DR PORT ST LUCIE, FL 34952 RE: Building Permit Number 1607-0349 It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal law. Za ;4z Signature Date 7/15/2016 2:15:28 PM