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Home My WebLink AboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /6 Permit Number: • NMI Building Permit Application OCT 1.2 1016 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 I/ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line W% Doi r PROPOSED IMPROVEMENT LOCATION Address: 7_66 .�'[,ee Legal Description: L56,{e5 - C(ui��' Ol0'- DLII /� /o7�s a7.�Sr' aq 3 3/ arrZ��2 /mop 3qJ1J5)�6P_ 3F112, -AP77) Property Tax ID#: 3Y6R_0 7- M76_- 60'-7 Lot No. 97--Y 3a Site Plan Name: _T;JJt'gAJ L'Ve r C57'4kS Block No.�— Project Name: Setbacks Front Back: Right Side: Left Side: s x, DETAILED DESCRIPTION OF WORK. ReMove ab)J 1'ep1ge_e -to eXJerio!' W©or5. DFroNf Door - .lc- +wiV TfitrM4-Tra Refjd/ae�- EMeC-10N P�ec�45,- R9Ts dae r- {tea r- Door - Vr wife 1Vt45oNi�e l'-DoNe� Si�ee% : 105 dear, -o I-- Ye „ 36eWP CONSTRUCTib"N ,INrORMATI'ON.. 3 t Additional work toa er orme under this permit-check all. appy: HVAC []Gas Tank . []Gas Piping Shutters ID/Windows/Doors QEl_ ectric Plumbing OSprinklers ,Generator 0 Roof Roof pitch Total Sq. Ft.of Construction: S : Ft. of First Floor: Cost of Construction:$ 500 Utilities: sewer Septic Building Height: OWNER/LESSEE : ACTOR: CONTR x , Name QA LLa Name: /fiey;A.)/ Aa)�11'0sz-e Address: aYS6 Nh- W;amr4'e /ve Company: ExCc/5/Or City: M i0m i State: F/_ Address: /,Wd s� Lrorr�/�� Ori✓P Zip Code: 331,90 Fax: City: �fl('f _�11 LtC(-f 10- State: FL Phone No. Zip Code: 341W3 Fax: 77a-011e 64Q0�o E-Mail: Phone No. !7,�-/-//R-2� Fill in fee simple Title Holder on next page (if different E-Mail: ,Ne7` from the Owner listed above) State or County License: (GG1sd/9 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: 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 our Notice of Commencement. IP�r�r` O_ �/LO/d 7 s Signature of er/L see/Con ractor as Agent for Owner Signature of Con a or/Li nseHolder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF �+ Lucre `'' COUNTY OF rcC e a) V�"rt I.ri The forgoing instrument was acknowledged befor rteR,� The forgoing instrument wa acknowledged before this 9 day of (�c �D Q 20 Eby o this day of Oc-1Obe�' , 20 L byJA E %'' • � n J m VL'7 � i R Xaa w �s� � � rr� asek (Name of person acknowledgin C= (Name of person acknowledging) m"E� (� ro -n LL aXa_11h& �C PT2 (Signature of Not#y Public-State of Flori a) (Signature of Not Public-State of Florida) a;N Personally Known OR P o ed Identi kation Personally Known ✓ OR Prod d I entificatio Type of Identification Produced �� Type of Identification Produced Commission No. (Seal) Commission No. (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS