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HomeMy WebLinkAboutBuilding Permit Application 1 . - ALL,bPLICABLE INFO:MUST.BE COMPLETED FOR APPLICATION TO_BE ACCEPTED Date:�' '� n ' I D Permit Number: Building Permit Application SEP 16 2016 Planning and Development Services Building and Code Regulation Division PEWnlT flNG 2300 Virginia.Avenue,Fort Pierce FL 34982 St. Luciounty, FL Phone:(772)462-1553Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: ,1C�L PROPOSED IM,RRgVEMENT LO.CATI9N: Address: //�-3 C r( `�!�`-)-5 �3� 11 1� r /` Legal Description:L•e�fL�GJc�c�d PLA, U n:. � ._ Z3l4 �6 ' LS� 2 Property Tax ID#:13©l r 0"2 -00 a �, -Oc)Q ` O Lot No. ze-1 Site Plan Name: Block No. 0 Project Name: Setbacks Front Back: Right Side: Left Side: IL ..D�}ETAI.LED:DESCRIpTION;:OF 1NORK: �}--_- _: aAV CONSTRUC-T,10N'.I;NFORMATiION: . Additional work-to be performed under this permit-check all that appy: _HVAC _Gas Tank _Gas Piping _Shutters _Windows/Doors )"ctric _Plumbing _Sprinklers _Generator _Roof Roof pitch Total Sq.Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: QM Utilities: —Sewer _Septic Building Height: Ol�IfVER/LESSEE =CONTRACTOR Name? U i roS 6'y (' f- ame:. Till C./ (44A fta Address: Company: City: WC (3P-CZ'AState:LQ- Address: t_ l J• s�� [� Zip Code.:?,?,f Fax: City: - - State(( Phone No. G-g 4 Zip Code:3 Fax: E-Mail:' LveNN 0,-6a(,U C6,0 , CGM Phone No. 3M bq Fill in fee simple Title Hof er on next page(if different E-Mail: PAW Q t;-A^ L�jXi��d���.•�� from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Nkc, 4� SU( LEfVIENTALCONSTRUCTION LIEN lA1N INFORMATION: DESIGNER/ENGINEER: t!�Not Applicable MORTGAGE COMPANY: _2�41ot Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: �Not Applicable BONDING COMPANY: of 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 thepermit holder to build the subject structure which is in conflict with any applicable Horne 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 exemptfrom 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 coe and posted on the jobsite before the first inspection. If you intend to-obtain financin ,c t with er or an attorney before commencing work o recordin your Notice of Commenc s Signature-of Owner essee/Contractor as Agent for Owner Sig at f Contracto Ic se Holder STATE OF.FLO IDSTATEUA�,/1 e_ COUNTY OFy COUNTY OF The fo•�r oing instrume was cknowledged before me The forgoing instrument was cknowledged before me this May of � � e`( 20 U by this It P5 day of I ft 20 11(- by '�ra J,A,151 hu I LAW"I (Name of person acknowledging) (Name of person owledging it I )�A.W'1-0 ( i nature of Notary Public-State of Florida) (Signature--of ary Public-State of Florida J Personally Known OR Produced Identification Personally Kna OR Produced Identifi)at* Type of Identification Produced Type of Identificatio !!�� oquup, Commission No. G (Seal) Commissionq o� _° , Notary MP cI-State of Florida My Comm.Expire Commission#FF 069425 Revised 07/15/2019 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE f COMPLETE INITIALS : ��'+ JESSICA LUISI A MY COMMISSION*GG0061b2i EXPIRES June 27,2020 : I 007)3860155 . FlorklallobrySOMC9 0m