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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLf INFMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date. Permit Number: 17Q Building Permit Application 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 PERMIT APPLICATION FOR: P'ROP©SE�D IN,PRQUEMEN L®CATION: Address: 5F5t J01405TIN 'KPAD R. FIF_RCE FL. Legal Description: ()AK6RID6F_ SUg pV(51613 �-� �1!}[C–(Z PMF_MVJT 4MA Property Tax ID#: — ODaZ ~b Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET ILED D'E�SCR+lPT10N QF WORK: E'L g5swE5-r5 AN 05P cTIolo Of - F- irm0T1 oN PUMP sFgylPRIOR Tc RE521RW6 PovJCFz Tv 'rf�fE �t11C�. CONSTR�UCT(ON I�NFORI�IATION: Additional work to be pertormed unclert is permit–check all t at app y: mechanical Gas Tank _Gas Piping _Shutters _Windows/Doors lectric Plumbing _Sprinklers Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ .� Utilities: —Sewer —Septic Building Height: ®UVNERf LE=.S�SEE: CONTRACl'OR: Name SSowxIoP c)F QAK8R,P6F- OMEDWNET,* JNL. Name: 1T0544751( rJ4JJTHFY,5 Address:5-61 ToN5ToN RaAP Company OMI- 5b–mc LV— City: FbU �IakLE State: FL Address: 766$ �adW6bP FDAD Zip Code: 34951 77�� --�� Fax: City: �7P�1 T� State:&- 1) Phone No. Q J� 7V7 Zip Code: .7-I �5l Fax: E-Mail: Phone No (7 Fill in fee simple Title Holder on next page (if different E-Mail 541KGV Y_r5_YAKW.GaM from the Owner listed above) State or County License E_(_t3bW-175 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 11110 SUPPLEMENTAL C®NSTRl1CTl®N HIEN LAUV I'NF®RMATION: 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: 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 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 comme cirig work or reqqrding your Notice of Commencement. Signat 0 ner/Lessee/Agent Signat Co tractor/License Holder STATE F FLORIDA l STATE OF FLORIDA COUNTY OF L—,�� �__ COUNTY OF The f rgQing instru ent was aacknowled ed before me The oing inst�ent as acknowledg fore me this�1 day of C 20 by thisday of 20 y c J CDC+ (Name of person acknow dging) (Name of person acknowledging) (Signature of N(4ary Public-State of Florida ) (Sign re o otary P lic-State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type.of Identifi ' n :D Type of Identific ' Produced Produced t ANGELA M HUFF Notary Public-State of Florida 7 �,µ;P•, ANGELA M HUFF ,•,,, Commission No. -01� �0�:: tary PuAeZd)ate of Florida Commission No. 5, =� _ : Q�MI)sion#FF 234730 ?•m - : Commission#FF 234730 J ',FOFF�o?°' My Comm.Expires May 27,201 N.w i oPc 9 =o-z�`-m Bonded through National Notary tR0MT-=-----YOMM onded through Natio al Notary Assn.REVIEWS ` SUPER OR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED �e_v_.7/2014 4.