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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: . Permit Number: Building Permit Applicati®n 'JUN 2 4 2016 Planning and Development Services Public Works Building and Code Regulation Division tee. Lucie moo ;, ;,, �t_ 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: ` 91AD S. Dl_ 2_0 Dr= 4ii A 1Z e Legal Description: `SQ n �©I ) Property Tax ID#: .35-J Z-t ba -pi�)oo - O 11) -_S Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: s DETAILED DESCRIPTION ©F WORK: �M9ACT I = C 6i' 23%= F:l-x°CL (t48) -rMPIAC-r C is i- C nnJ_- CONSTRUCTIOW. ,MATION: A Itlona wor tome under this permit-check all that appy: HVAC Gas Tank 0Gas Piping _Shutters Zwindows/Doors Electric ❑ PlumbingSprinklers Generator ❑ Roof Total Sq. Ft of Construction: SFt. of First Floor: Cost of Construction:$- 39 DIS 7.`�o Utilities:cn Sewer[:]Septic Building Height: OWNER/LEz,MR : C«©NTRACTOR: Name QS 27rd dAk PIVS, ) Shur Name: Address: /446 S-0QQ '!)!; )2_5A Company,;.A- 1-,ta-) W c)c City: Men-c'n'1 &ack) Stater Address: OLDI cAL10C 1 ilt —oz Zip Code:_34 q57 Fax: City: - I,1,(>C r State: Phone No. - (72A� AAA 5369L Zip Code: ,��1^SJA Fax:nbl 743-25,32- E-Mail: Phone No. `;bi 7_H_-3—qLQZ9 Fill in fee simple Title Holder on next page ( if different E-Mail: r� M 1,Jlriy from the Owner listed above) State or County License: CzCJbS9551 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I83002T.TAL CO S"TRtJrr lQI L E 1 �AUV IiNF+�R Al`{0 1 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 ' . If you intend to obtain financing, consult with lender or an attorney before comme work or recor In our Notice of Commencement. N>� - ". s _Signature of 0 essee/Agent Signature of Contractor/License Holder STATE OF FLOR I STATE OF FLO COUNTY OF COUNTY OF T e oing inst�nt was a knowledg before me The for oing instrum was acknowledged before me ctJ r day o 20� y this n , day of 20 L l/l by (Name of person acknowledging) (Name of"person acknowledging) Ignature of Notary Public-State of Florida ) (Signature of Notary,Public-State of Florida ) Personally Known OR Produced Identification Personally Known " OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No.21E om fission No. �J�Z Seal Q;r'y MELISAARMENT MY COMMISSION#EE 81.5 825 �;',!r •.,, MELISA ARMENTO 2016 a �k= Pr R-q9APr, ....Z!' Bonded Thru Notary Public Underwriters , `= �(pIRES:December 28,2016 Revised 07/15/2014 'RPFhc$ Bonded Thru Notary Public Underwritem REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE `7(� INITIALS ��