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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUSTBECOMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVE® Building Permit Application NOV 2 3 2096 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: PR®P®SED IE:zN IN L®C//ATIp'N: Address: � L17 s!wly r_i l E/er-. a!�5Ye Legal Description: Property Tax ID#: /�-2�–,5��/� (�(7i�'O ® g0'/ Lot No. Site Plan Name: Block No. Project_Na.me: c! Setbacks. Front Back: Right Side: Left Side: DE AILED D CSR 0 +DF 0 � K• C®NSTRUC I0 I ORM: T ©N: IWI-tional work to De pertormea un er t is permit–c ec a t.at.app,y: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors `° Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor:, Cost of Construction: $ 00�%9 'C— Utilities: _Sewer _Septic Building Height: 0 1'04110111 ACT• Name 's 9 S' , i� Name 1W 1-Z l•� Address: 9401 � V_64'!yi W ` Co mpany: yr®l City: d ° [�'Y�r State:� Address: 4-¢1# 994 �} d� G� Zip Code:�?f,7 Fax: City: L State: Phone No. , 2 –70 Zip Code: Fax: AC24 E-Mail: d Phone No Fill in fee simple Title Holder on next page(if different E-Mail co from the Owner listed above) State or County License if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S`j'� SUP'PLEME TAL CONSTRUCTION IEN LAW N -� • � 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: OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit toiao 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 t ancing, consult with lender'or an attorney b'— '�.a.� commencingwork or recordingour Noti � encement. _ b; •:t:: s+1: r �J Signature of w r/Lesse tactor as Agent 3Qµ re�r nt_�_ _tactor/License Holder � o0 STATE OF FLORIDA 1/ r.E j STATE OF FLORIDA -� COUNTY OF �T • 5' COUNTY OF w Q The for oing instrument was acknowledgeq befor e, The forgoing instrument was acknowledge be gng thi day of n � 20 by �� this day of u7j. 20/to b ,R.'GN — m N H _D VL (Name of person acknowledging) (Name of person acknowledging) (SignatureOV otary Public-State of lorida U (Signature of ary Public-State of Florida Personally Known OR Prod ced Identification Personally Known roduced Identification Type of Identification Type of Identification ` Produced �" Produced �- Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW -.REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Ve-v-.772014