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HomeMy WebLinkAboutBuilding Permit Application i Alf-APPLICABLE INFO MUST BE:COMPLETED FOR APPLICATION TO BE ACCEPTED r Date;" �� I Z I fl Permit Number: t RECEIVED _ ___ Building Permit Application SEP 12 2016 Planning:and Dev61opment Services Building and:Code Regulation Division I; 230U Virginia Avenue,Fort.Pierce.FL 34982.. I E: Phone:Q72)4624553 Fax:.(772)462;1578 Com:mereiai Residential PERMITA.P0.01CATION FOR; PRflP• 'EQ MPR. V � i. ON. _ Address �, E(Portn i LN Legal Description:. .. n. .36 40 : 001�-�.. .QF �C k' Property Tax ID#:; lot No._ _. Site.Plan Name Block No. Project Name: _ t. Setbacks. Front Back. . .. Right Side:. Left.Side::.. � QE'T'A1[.ED � E-�CE� 'TtQN • 1"N� R Qr rp- k Cil�- S C STR�lC77O [NFQ (M +N: ¢; nalworl(lolbelperformed un .ert_is permit-c ec a tat appy: I. ZMecha.nical _Gas Tank _.Gas Piping _Shutters ? Windows/Doors Electric —.P"lumbing —"Sprinklers " _Generator _Roof Total.Sq. Ft of Construction: Sq. Ft.of First.Floor:" Cost:of Construction.$. 210C) • CM Utilities: —Sewer _Septic Building Height: U PMISE t �I('3�C LC.�'l 1�.Q ]X. . . Name: Name L L -hal I Address: El ©I"'1C� P LI'l1 Company: SMI P K I-rfr CC�irl(`)9 Calf City.: Port S'�' State: Address- 571 BUG) Mex cm b t Zip Code: 34 C452- Fax:: City (fiat' s� Lar► Stater Phone No 772 2 3 4 028 6 Zip Code: . 34C424 Fax: Phone No.77 2 70Q P9 Q C) E=Mail: i Fill in fee simple Title Holder on;nil page"(Wdifferent E-Mail: r e cC lC�dllMMCC .q A - C-C)I-� i. State or Count ense: CAC 1P 16e3 l from the-Owner`listed y .above) Lic_ Gl" f. If value of construction is SOO or more,a RECORDED Notice of Commencement is required. r. i f J ., AM— DESIGNER/ENGINEER. _'Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name:. Address: Address: City: State- City; State: f Zip: Phone: Zip: Phone: t FEESIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not.Applicable Nam' _ Name: 1. _. i Address: Address: City: City: .. .. - ... .. .. Zip.. I Phone: Zip Phone: OWNER/CONTRACTORAF, DVIT Application is l e.reby made to,obtain a permit to do the work and installation as indicated. I certifythat no work.or installationhas conimericed.prior to.the issuance of a permit:. St.:Lucie Counttyy makes.no representation that isgranting a permit will authorizeahe permit holder.to build the subject structure. which is in conflict with any,applicable Home Owners Associatiomrules,bylaws or and covenants that:may restrict or prohibit such se structure.Pleaconsult'with your.`Hom.eOwners.Association and review your deed fo.r any restrictions.which may apply. In:consideration of`th.egranting of this requested permit,.:l do hereby Agree that I will,in all respects,perform the work in accordance.withthe approved plans,the:Florida.Building Codes and St.Lucie County 4mendment$. 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 fir'st inspection. If you.intend.to obtain financing,consU'lt..vvitK lender or an attorney before commencing work or recording.voyr Notice of'Commencement. Signature owner/`Agent/'Lessee Signature of Co or/License Holder :STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ��LI-C COUNTY OF _ C1.,a,4. Theforgoing ins hent was acknowledged before me The forgoing instrument was:acknowledged before me N� this J day of hannbet' ,20jUt by this Z`e'd- of ICO by i2Q in:b��A nfi!��- (Nance 6-f porsorra ovule .ging) (Name of person nowledging). (Signature of Notary Public-State.of Florida) {Signature of'Notary,Public-State o..f Florida PersonallyKnown OR Produced.identification.: Personally Known_ " OR Produced identification Type of Identification Pro ype>of Identification Produced- _- ;`: , �8� 0RAH RUSSELL ��.� 'v�I'e Commission No:. a ommission Na: (SeWhORAH RUSSELL . N��ar'y'Public State of FloridNotary Public-State o1 Florida ?y o. Commission*FF 179630FF '' • Cdymflires r4ow '•.,oss�gP•' My Comm Expires Nov 0.�p16 REVIEWS FRON LANS VEGETATI NGR6VE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVI . DATE RECEIVED .DATE. :COMPLETED ev.712014