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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:J�� �-�-! CIS S� • Building Permit Application JUL 6 Planning and Development Services PER"vilTTiNG Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential `+1 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 61V 1e7cz) �R L Legal Description: ye-I( Pc"c iS i)y) ► + - G K 1 q' L~ep t 7 Property Tax ID#: `l �� �/� " D.Z -UCO' 4�r' Lot No. 7 Site Plan Name: Block No. Project Name: Setbacks Front ✓ Back: Right Side: left Side: DETAILED DESCRIPTION OF WORK: T e4 r d�� ' n S po S S I ©F Yi c' d©c3, -zr-, I n S eek 7 CONSTRUCTION INFORMATION: Additional work to be nertormed under this permit-check all that appy: HVAC Gas Tank Gas Piping _Shutters Windows/Doors 11 Electric a Plumbing Sprinklers F]Generator Roof Total Sq. Ft of Construction: — Sq. Ft. of First Floor: - Ing Cost of Construction:$ �/11r�. Utilities: Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name AAo._c!A c G► vt Il S Name: .3 f> �' �-�p -z- Address: 4�5©® Address: ©® G!, ✓'f_ . Company: 15t (f 1'e c ea r� City: C-� f— State: L Address: /fj/7 54,rl A'//i�5�%J �✓2 Zip Code: 3�/135a Fax: City: to,, .E 't Sf State:E(--�c ."� Phone No. Zip Code: 344 2,513 Fax: E-Mail: Phone No. -77Z ,,37d- / %6 Fill in fee simple Title Holder on next page(if different E-Mail: g4 a, I u 4 ac • 'o.zi 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 CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: I / Address: Address: In 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 commencing work or recording your Notice of Commencement. V/ Z�( 7 S siatuee-of&�vnerkL see/Agent Sign re oT Contra ctor/Lice n—st"N older --- V STATE OF FLORIDA STATE OF FLORIDA COUNTY OF. 6T, LOCI C, COUNTY OF f S T, LL) The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this25:day of JJ L y 20 L.L/_Lby this 2&:day of_J JL Y 20 /6by ?A-� K LEA4 (N o person c now e ging) (Name erso cknowledging) (Signature of Notary Pu tate of Florida) (Signa ary Pub lf-Ate of Florida Personally Known IZOR Produced Identification Personally Known it OR Produced Identification Type of Identification Produced Type of Identification Produced Commission NO. (SePWR176A HERLEHY ommission N Notary Public-State of 3Florida V P PATRICIA HERLEHY my I:xpjFfte 1qJJn 01 Inj I Notary Public-State of Florida )9 My Comm.Expires Sep 21,2018 Commission#FF 129908 Revised 07/15/2014 OF 1 1)' ar ssn. Commission# FF 129908 Bontled Tlyouo Naltional Notary Assn.. ElondedThrmoNational Notary 7HEEHY Florida 1 2 1.or 018 2 go State 21 ate 0 Expires Sep # FF 1 9 8 iaW Notary Assn REVIEWS FRONTZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS I I r I