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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i, \ �II" Date: Permit Number:, l l ' oa3 o Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 i I Phone: (772)462-1553 Fax: (772)462-1578 Commercial i Residential _ PERMIT APPLICATION FOR: i I.I PR�®P®SED IN,PR®vEME �.00ATION: Address: ,30 O►'D Ora n(L Legal Description:LrA eocjc &,g#-WC4J ? 0; a6 VO Flit>/Pa,11 af'c d4 1Y6 eel Oy 1 �qJ .lAiot.,rg zo.,- -7a,O Lo.,/ JO � Property Tax ID#: 6 -.SDO 62D3- 00 0 '2 ! Lot No. Site Plan Name: /li�.0 i. Block No. J Project Name: QO 0 Setbacks Front Back: Right Side: Left Sider DE AIL�D DE�SCR PTIO'N Of W�'R : 10 o �: I it I CON�TR CTION N�FO`R+MATION: Additional work to be performed under this permit-check all that appy: j+ —Mechanical Gas Tank —Gas Piping XShutters. —Windows/Doors —Electric —Plumbing —Sprinklers —Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floors v� I � Cost of Construction: $ 302 Utilities: —Sewer _Septic Building Height: 0� ER LE�S�SEE: C®'NTR CTOR. Name Akonwq X Name: I 1fie- Address: i / Address: 3 O O/O Ic[P?;1e ti Company: O J�1 .4'L J catid✓ City: O/�c./ G✓crt State: R: Address: 62 3(' cf ':'L.ic1e ial- Zip Code: e,T2- Fax: .v�iA City: Al. e ; Stater Phone No. Y yz - viad Zip Code: ,?V'7 Fax: 77?-416/-/SSS E-Mail: Phone No ZU-&JI/-1 all d Fill in The simple Title Holder on next page (if different E-Mail fLIfval'ue the Owner listed above) State or County License,1. _Ce C!.3//Sl SO� of construction is 2500 or more,a RECORDED Notice of Commencement is required. i I , ' I i SUPPLEMENTAL C.ONSTRUCTI©N LIEN LAW IN�F®R�MATI®N: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: 7A Name: Address: Address: City: IfState: 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 thepermit 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. 1 7 � 4nature of Own e Lessee/Contractor as Agent for Owner Lqgnature of Contractor/License Holder STATE OF FL0 ,tn STATE OF FLO7�, COUNTY OF v��.1�.2� i COUNTY OF The o in inst t as acknowled d before me The f in ins e�t��((,,a,s ck owled ed before me this�ay of 20 O by this ay of " T1G' 20_ by _NO�Z (Name of person acknowledging) (Name of person acknowledging,) r r (Signature of Notary Public-State of Florida ) (Signature of Notary Public-State-'o—t State-'o-tFlorida) Personally Known ar r1AdPnti&r;it0Qj;iPersonally Known Pro uc Type of Id t' i ' t :'_°. °��'� KRISTINE HOPKINS Type of Identif' t' ,,�P"P�.,, .`�= e KRISTINE HOPKINS • fl Notary Public-State of Florida Produced J` Produced ='» = Y RYlic-State of Florida ,r� Y omm.Expires`Jan 7,2017 My Comm.Expires Jan 7,2017 „0;;;4 Commissi Commission No. %rF °?�� Commis �l�EE 851612 Commission No. Q9e�aky 851612 „..... REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014