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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t Date: Permit Number: I I r f ® t, Building Permit Application OCT 17 Planning and Development Services PF Buildin and Code Regulation Division ������" 9 9 SL c 2300 Virginia Avenue,Fort Pierce FL 34982 qty, r` Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line - •.C� :'�T:v'���:+.r'!i:is�>' .fp•:^�:.� 1_ +Y R Address: LQ 1' Legal Description: CmIdM anciS P—Oncobr, Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back:' Right Side: Left Side: -SCR •'.�t\:1 :5... i:'S.-. .`�{ �.:j est.! .•c. ��_::i, - •:f�.'. •.�' =DE�FAILED=D.E�'� �f•'TI N= fi-�V1l: �R ._ � :, ,...;,1.,�•P.,. O 40 .,, O L �•. J�,,� .,.r: .. : •.. . .... ♦ ....0 to...- .. .,. .. ..'.r w.-r ,.. .r.a:. .•,'a,.y::t, �`,`..t 4'r`•. J:�:mit.•.' it{.'.�`:;!-:hi[ (m o_ 44om f) N• .?C - .U.CTION`�INFO A(laitional worK to De performed under this permit-ChecK a appy: HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors Electric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: 1990 S . Ft.of First Floor: Cost of Construction:$ �J ,pn Utilities:�Sewer ElSeptic Building Height: ,r. _v.5.a �e s ay. ,a lry�:lt?x .,wf•{''.*,•x:F;�ansag, ';at;,• amt`,:µ`:sL_ ry. f• :'ii^ .r, r,.,r L'+4k:.>:.•ti':tJ�>rbl.Vye4,A,ah�. �. ,.,{..: 9 �1' •.� 1 �Y .i. wc1.iM1> ^'Sr it f.. .d2 ..`?-.t,wR.. .ihFrt'S• 1... ):r. :.�, ..,:.._.__...,::,.... ...._..•_..,...�... .. :::...:...�. ...�.r,....r.,..>r,.,:Z.,. ,e,a..�.... �..i�'t., t.. .:M,a•.w-r:rs.._ ,:.,[!. tic_. ..r..: Namekyt Address: 1p Company: 11 City:—f-Y)i(Ad te-+0LA)r) Stater Zip Code: (pQy Fax: City:_ 'tai P, ce State: I_L^ Phone No._ g'ti 5,- c i $- Q0(3 Zip Code: 131-1 q goo Fax: flay-6600 E-Mail: Phone No. Fill in fee simple Title Holder on next page (if different E-Mail: )r'—nn 0 A 1a from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. y:.!J. <: a:}mala.. ;�.•, • ,J ' .�.�,.Ei.I:.VI.-E_:(.�.,:T...y'.ti..,`L..a:Cab.a.`;:�....Na•.`' .r.• .,a,; ' .`y,;'.2 wj�. :F,iQ i r Vt - aA ­;:7 '7 ••, ..�seap...y?.Y.s �.�.:r - .y-..Y'^t1:^_'.Y7." r.r• alb.. _ a.:� - a"'- _i.. - 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 App licable 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 app y. 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 j obsite 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. L11aA ///./"l-,� 1/4-,I Jq Signature of Owner/Agent/Lessee SignWe e 0-contractor/License Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF 5'I- l � _ COUNTY OF LA A-W , The forgoing instrument was acknowledged�efore me The forgoing instrument as acknowledged before me this 1Z day of ©C4r,b-e r 20 1 by this L2 day of ti 20A( by _ � r Aad (Name of person acknowledging) (Name of erson acknowledging) (Signature of Notary Pubfi -State of Florida) ( ture of Notary Public-State of Florida) Personally Known 7OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Produced Type of Identification Produced 111 Commission No.L5ls 0( °1� tiAYPu�(Seal) p� Commission No. 0b (Seal) o�,...�. 4JlY♦ * * MY COMMISSION 01 GG 003937 a°,•••, (, FAITH M,SON OFtto°�� BwAodTlwBuA�tNo�YSNNy� a� 7 E PIRE&JuN20,2m Revised 07/15/2014 '+oRno�° Nf*drnme� , REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS