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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �• 1 Permit Number:-44 RECENED - Building Permit Application AUG 9 2016 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: PROP05ED I'NPROUEREM T �TIO'N° : Address: ; Z -7A1 )eJ,`A&S] LN 19�/ Legal Description: ��-W S© �� ��Ol�l �/ 7`� 'C Property Tax ID#: 3 2 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: . Right Side: Left Side: DETAILED DESCRIPTION flF WORK: CONSTRUCl'tON (NF®RMAT(ON: itiona I wor to a pertormed under this p&—mit-check all that appy: Mechanical _Gas-Tank _GasPiping _Shutters' _Windows/Doors Electriclumbing _Sprinklers _Generator _Roof Total Sq. Ft of-Construction: Sq. Ft.of First Floor: Cost of Construction: $ '7 s �— Utilities: —Sewer _Septic Building Height: OWNER/LE=�S�SEE: C®NTRACTOR;: Name D0 C' I k Name: c� ✓�G r'> 1"Y J!� Address: Company: 144y'r':z)46f City: S State:_ Address: /7 �� 6� 't(P c< Zip Code:, g Fax. City: State`- Phone No.p r- Zip C de: ?Y9 PY Fax: E-Mail: b�� mg\/`,zk � ( � CcaQs� , nl c-} Phone No- -7 '2 Z 1--?J l/-S^ e � Fill in fesimple Title Holder on next page (if different E-Mail 14(4V�✓p�f e Ph tib OL,,A Ca � from the:Owner listed above) State or County License R"� (��6•? t� ' if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. IMF Sl1PPLEMENTAL Ci�NS RUCTION UEN LAW INF !RMATIDN: 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: 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 represent ion that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applica a Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult with yoHome Owners Association and review your deed for any restrictions which may apply. In consideration of the rantin pf this requested permit, I do hereby agree that I will,in all resp",perform perform the work in accordance with t appro 6 d plans,the Florida Building Codes and St. Lucie County Amend ts. The following build' g per '"applications are exempt from undergoing a full concurrency r vi :room {ditions, accessory structur s,swi ging po Is,fences,walls,signs,screen rooms and accessory u s o anot non-residential use WARNING T WN R:Yo failure to Record a Notice of Commencement resu your paying twice for improvemen to y `r pr erty. A Notice of Commencement must be ord d pasted on the jobsite before the f' tins ectio . If you irr}}.tend to obtain financing, consult le ar an attorney before commencin wor or r ordin tSur Notice of Commencement. Signatu f O er/Lessee/Agent..,= Signat re f Contractor/License Holder sN . STATE F FLORIDA mz�a STC OF _ z COUN OF s N m C UJ The f r oing instru t was acknowledged before aox The fpr oing instru t was acknowledged'before Ux this day of 2011 by a this day of 20Lp by (Name of person acknowledging) Name of person acknowledging) (Signature of Lary Public-State of Flori ) (Signature of t ry Public-Stat"of Florid Personally Known OR Produced Identification Personally Known�_OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.