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HomeMy WebLinkAboutBuilding Permit Application F ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 Permit Number-\ ~(::��� 3 R> CEI'.'__D SEP 4 ? ►fi Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982. Phone:(772)462-2553 fax:(772)462-1578 Commercial Residential PER IT PPLICAT CW FOR: PROPOSED IMPROVEMENT-LOCATION: Address: lcoK2, Nr_C( bv- Legal Description: 1..�Q0A 50,06'S ���© --tl`2� 00kk '122 Property Tax ID#:'NQr5_1;_)6_W12),ooc> y�_A Lot No. Site Plan Name: Block No. Project`Name: Setbacks Front Back: -- Right Side: Left Side: DETAILED. DESCRIPTION,OF:WORK: tr2.ep�� w,nc�c�S t 600r`Z, W:Ah irnrzx Caw cuss om W,njows Cn 1%CLU5 CONSTRUCTION INFORM4TION: '?, Additional work to be performed under this permit—check all that apply: HVAC _Gas Tank Gas Piping _Shutters Windows/Doors Electric Plumbing _Sprinklers _Generator i Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: 1Q1 1 . ( scr�- Cost of Construction:$ �f)�.� Utilities: ,/Sewer ,_,Septic Building Height:_L2!_� OWNER/LESSEE Te(01c� I-� -JSwNe,$ Sn,� 1�, CONTRACI°OR: t.�rat C x-�kcoc��y acs r Nanie Name: Address: Company: City: state: Address:' 31 Zip Code: Fax; city:qJ r 9"ev cy- State: Phone No. Zip Code: 3uq14 S Fax: E-Mail: Phone No LAZ71-S-031 Fill in fee simple Title Holder on next page If different Q2 WV, a� from the Owner listed above) State or County License:CCC.151 L45 Cis If value of construction is$2500 or more,a RECORDED Notice of I required. SUPPLEMENTAL CONSTRUCTION..-PPIJAW 11\117PRIVIATION 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 inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement. A� S _Signature o O n 5 /Agent Signature C n ct icense Holder STATE OF FL DA STAT FLORIDA COUNTY OF 5�- 1--�C.�� COUNTY OF_!sA.1-uC'\e The forgoing instrument was acknowledged before me ThT forgoing instrument was acknowledged before me this this`d day of 20 G by day of O t- ,20% by (Name of person acknowledging) (Name of per n acknowledging)' (Signature of Notary Pu lic-State of Florida) (Signature of Nota Public-State of Florida) Personally Known OR Produced Identi �1�97 � Personally Known OR Produce Identification Type of Identification Produced L R�G7 Type of Identification Produced �- L Commission No. ' . _ ��o Commission No. MgR1E GIVEN' •''•ti's' s COMMISSION#GG Ou023 Revised 07/15/2014trEa' <` eo+ IR>=s.o�m . • ThN Notary Publk Unr.c%riri o r r �':.Bdi�.R• ` i NNIN !������� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS