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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: D cs OCT2 � "1 r e Jig Building Permit Application PEF;:v3iTTii1G Planning and Development Services 5t. Lucie County, FL 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: To Select from dropbox, click arrow at the end of line win�dssf PROPOSEQ IIViPEQUEMENT LQCATIC?11 ' Address: IC)(080 -:; ocean Drive Un i"1- Zlo Jensen BC-110 h F L 34-g 51 Legal Description:151clr)Cy 0rcSI' c )r,6omitniuVY) c - it 7 10 cal-)0I (ArY1Nr. ShQer2 Ih cornrnc+n �t�me�r►fie. Property Tax ID#: 4-511 - 5l(o- 002 7-CCX9-O Lot No. Site Plan Name: ISl(aro C1'c-st• Block No. Project Name:RQQC�,L RPSiCf'C)C_ Setbacks Front Back: Right Side: Left Side: Df 777, C3fi 1tVQ;RK, y n #. _.. _._. Rcmovf' cLn©1 replace- C2 ) sll(ji r)9 910ss •wj+h non-i ry) P LCA, Ct�s�r�er ho-S eX i S+i n 9 ShL_A_-J-he rS 0 "NSTRUCTIC�1 INFURM TI(3N ' ti Additional work toe e orme under this permit-check a appy: HVAC E] Gas Tank Gas Piping _Shutters Windows/Doors 11 Electric ❑ Plumbing [:]Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: SFt. of First Floor: Cost of Construction: $ 3;QCT . ( Utilities:In Sewer ElSeptic Building Height: OW( ELSSE � rF�r Y C(71VTRACT�OR a Name MLY)f. NMCI N" me- f)r1V o(0an -1; no-eon rive u 210 rnpany 1..•j, ,ti �;;+ IaSS:,Q,..,,T Address: Yli� C city: .ifopSnn eenc- l State: FL. A dress: "1O'` ' 11It ` Et ;. :•..a�:: Zip Code: �4� n jQ y: 1� _ �f+� ,:,s:;�r,:h,, / ��� Fax: C, :.r � F r;� r' State: [=L Phone No. -Z1Z5 ZiCode: Taa� .,,�,•;n 231— Z�-1-(r� p �l.l-��� Fax:• 772•2!B(a" of-!"lol E-Mail: Ka(r-. Phone No. -1-7a,7_8(o • ©4SC Fill in fee simple Title Holder on next page(if different E-Mail: iri}Spy(G �oyYtQ�Q -e�rM from the Owner listed above) State or County License: j R3(c 2) If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SllPPGEMENTACON5TRl1CTl{ N GIC GAIN I1VQRN�ATION 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 improvemepts to your property. A Notice of Commencement must be recorded and posted on the jobsite before thelrst inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or reWrding your Notice of Commencement. s Signature of Owner/Le see/Contrac r s Agent for Owner t ractor/License Holder STATE OF FLORIDA-- ,, ` STATE OF FLORIDA COUNTY OF I'YICff /1i COUNTY OF The forgoing instrun ent was acknowledged before me The forgoing instrument was acknowledged before me this a3 day of 20fok by this day of 20 by DOne 1 N0ga (Name of person acknowledging) (Name of person acknowledging) (sign atu reVIN otary Public-State of Florida ) r/ (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification V Personally Known OR Produced Identification Type of Identification Produced L Type of Identification Produced ALI- - NO 44W1 MANCommission No. Notary(tt�b�f -.State of FloridaCommission No. (Seal) Commission#FF 929255 8olldetdltlroU�l National Notary Assn: Revised 07/15/2 „ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS