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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` Date: Aro . Permit Number: .M RECEP.'"D Nov 15 7 16 Building Permit Application Planning and Development Services t Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:-(7-72)462-1553 _Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line S�v PRPOED IMPROUEMNT L°OCAT�;ON � r ` ff i A., •• ee, . Address: �1�� POI a��t i115 Z...Q Legal Description: P'c�s� 'Z(o t—:i�i Property Tax ID#: �J' 0®1—coal Lot No. Site Plan Name: Block No. Project Name:- Setbacks Front Back: Right Side: Left Side: _,a -Pa ,x;,n..,l•. ., .. ':a .+.,., .,� �.,...n n-w!°tr- ,i,.•�• ,,.,,� r£ .. ..s ....c- —r` ?f.•i.�{ .. ._ 4 ....... :. �5 ����d� o• ©pe h(-co? ':S a, 33a tf: fil,at�i-J F' 1(U �y P t!3 ; '•t} _ !FL, f f' }_K *L;v3id(`: CONST UCTIN ){�1 FORMATIO , Additional work to e ertormed under this permit—Check all tbWzb, ply: HVAC Gas Tank Gas'Piping _Shutters D Windows/Doors ;, .. Electric 0 Plumbing Sprinklers E]Generator Roof Total Sq. Ft of Construction:. Sq. Ft.of First Floor: Cost of Construction:$ zgoc Utilities:Sewer Septic Building Height: r t 5 p Fa J S s' � t �- S r "ms.S�- `"�„ 3=` � , ( .k�'a r ���� X7:1:5 { f � `� e s'^��•-: 01NNELESSEE, ,r, a, �, , £ , : . „ CO NTRACTCI a• .IM, 7+.i ,.'a f .S £ , 3 £ ���'., a_rir F. :�': �h„i S.It„ /CO Name: _ ��Name• Address: 7Pn' ; .:: %f5; :.:/ Company: City: Poll--.v: tate:FL.4 Address: 26NO S 5 '11 Wil. l2J Zip Code: 311q'gt Fax: City: l State:--k—(— P h o n e tater(.Phone No. 7AJ X4-96`70 Zip Code: ---3yqFax: E-Mail: teAlAICOA7 (D da— C07-4 Phone No( 11) '3V2—(0qZ Fill in fee simple Title Holder on next page'(if different E-Mail:.Bd_6a_V' &hQ,(0(:tu!J (11Au`�►-�ac�l tom' from the Owner listed above) State or County License:j p c k'?> q S If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. { SLT;PPLEMENTA ,,� ,i{ ,, , ,xs .a ,r_....,. _, n DESIGNER/ENGINEER: ' '` Not Applicable MORTGAGE COMPANY: .Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions'which may apply. In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:roam additions, accessory structures,swimming po s, n ... w fealls,signs,screen rooms and accessory uses to a n-residential use WARNING TO OWNER:Yo failure to Re ord a Notice of Commencement may re It in your pa ' g twice for improvements to your pro erty.A Notice f Commencement must be record and pasted o the jobsite before the first inspectio . If you intend to btairi financing, consult with lend or an attorney efore co men in or r G r in aur Notice f Commenceme r Signature of Owner/Agen7se% 'Signature of Contractor/ en H01der STATE OF FLORI A STATE OF FLO IDA COUNTY OF - L» y t ♦A_ COUNTY OF UJ The forgoing instrument was acknowledged before me The far oing instrumentt�was acknowledged before me this day of ?,S Q-4 201' by this v day of 1JtTV 20—%by t i t ���b V 'C 1 S �G$ �' '�,. C ��►�n�?Sy`�a.,l S d4G�! (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary PubliU State of Florida) (Signature of Notary Publi State of Florida) Personally Known [IWMI*fin Personally Known 0 MART moo_ Type of Identif' ry►,{��,4, acedD _ 0 Type of Identification: aY erg I. :I�W� 1y��(� ln� is �N C��I�IMIW 1�(�LV i: Commission NoNbwi " Commission No. {Y1 � b �IicU�t `� WOOF1:�,•� �wc gpnded . Revised 07/.15/20.14 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS