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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I J Date: 3` t!, Permit Number: J �� Building Permit Application 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: 111-1 lt 'CJE© INPQ1fEIVT DCATIC a R s b a,, . .�, . , Ai Address: ���y G SP(,i 4 cc F< Legal Description: `614(yl d IZUV S- 3-1 2914 A Z , 9 Property Tax ID#: Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ,a s DETAILED C3E5GR(PT(t�N }�W{ RK;az a� '' ;01 d'. CSC SMME & �.SO M 6 AIL .5 qSi 1=M �/ �/Ccs CO'NSTRl1CT({7111 tN1=ntMAT(Ofd -.- _� .n_..� , ��.. A. . � .. t �.. Additional work to be pertormecl under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors Electric _Plumbing _Sprinklers =Generator _Roof Pitch Total.Sq. Ft of Construction` Sq. Ft.of First Floor: Cost of Construction:$ T zU V i Utilities: Sewer _Septic Building Height: ea COIUTRAGTQR � . Name - Name: Address: S1Iy6 S. r�gz��� Company: (2—/ K City: �I� CE State:P Address: _C3 3 NL /' t,rzt zdA/ Gv Zip Code: Fax: City: Stater Phone No. 9'17'z PG! soycl Zip Code:� yG Fax: / E-Mail: Phone No J275t1 Fill in fee simple Title Holder on next page( if different E-Mail !:�Z 1/04 4,e; LCOlt/r25-5` + /-A from the Owner listed above) State or County License b C-0�=J Z S 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: 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 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, l 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 comme_neHqg work or recording our Notice of Commencement, Sigriatufe of Owner/Lessee/Contractor as Agent for Owner Signat .e Co ractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF � The fo,rgging instru ent was a knowledg�d before me Theo Ing instr ent wa ,acknowledgefore me this ay of ' 20 by this day of 20 by (Name of person acknowledging) (Name of person acknowledging) � ,M C� �ature No Public-State of Florida ) (Signature of Not 'G_ ir* to of Florida) Personally Know R Produced Identification Personally Known 4° ° ro�uced� tion entification Typ "catio ." °tar"ub CAtyHO lid- FF u ,;. oa ANGELA M HUFF Produced %;�F Op'� 00mmis.� State Produced -. FIOP.�� Mton#FF23��°rrda lic-State of Florlda commiss' n e0170le m'�kPiresM' 30 Commission No. My Comm. jgj)Ma214730 Commission No, hr0u9h narNy2�?Otg Y 27,2019 aa�' Bonded through National Notary Assn. Not�yASSn - �.. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.