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HomeMy WebLinkAboutBuilding Permit Application (2) All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: 1(1Ok Permit Number:Rnffi �� it �I` �.� c,'Tu '� +Far.2 s `� - RECEIVED EMM Building Permit Application NOV 16, 1016 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 1/ PERMIT APPLICATION FOR: PROIPOSED INP�RO >EME T �OCAT!`OWM dY .i.e�i a$raerz#+d« 7.rr :r.rs,-csi—.e� s �.xd:�i-L -,.i. ., _ ..'�1._. _.. Address: 7,%3 bleu. &aK 81vel FmrA Piero,.FL -31111151- Legal Description: Property Tax ID#: i 36(- (,07- A O ZZ-600 -G Lot No. 2 d? Site Plan Name: Block No. 76 Project Name: Setbacks Front, Back: Right Side: Left Side: DETAILED DE�SCRI '1`ION OF OR 0—iR?I ;. h •.y _ .t / 1 IS�PJJc F)cSi+ink. Attar Lu k A hurrirdAe door R� Add_ CONSTR�UCTIO�N3 INF'ORMATIO`N o itlona w ork to be pe 19rme • under t is permit-c ec,la. that-apply: Mechanical _Gas Tank _Gas Piping.' f Shutters Windows/Doors _Electric' —Plumbing —Sprinklers"" '` _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First-Floor: Cost of Construction:$ Utilities: —Sewer _Septic Building Height: OW=4jER%LES�S:EL: r CO.NTRAC1'OR:: Name 71303-&4,s A -t< !Sive Proa.au ?raft Name: zK��a rlcT Address: X74(. 13 M1I'.iir'y 'TrL Site l Company: Q pec.(^ V City:_ (de-S-17 PMAft Aeztk,l'=L. ,33L11d State: FL Address: yfR,-g-iuw& lgae.rjda ITLue) Zip Cuae•- (t© Fax: City: PSC_ Stater Phone No.— IV- 761-5 f'YC Zip Code: Y4x3 Fax: E-Mail: Phone No M-A?,g-tYZ/ Fill in fee simple Title Holder on next page (if different E-Mail d't'ec d:,dsrr :e_AnBr`raG3 .C'nHt from the Owner listed above) State or County License If value•of construction is 2500 or more,a RECORDED Notice of Commencement is required. 110MMM.,MONOMERS L11 EIS 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 commencing work or recording your Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Signature of Contractor/License Holder STATE OF FLORISTATE OF FLORIDA COUNTY OF "m< COUNTY OF,_ = :2 The f %oing Instrument was acknowledged beforE The forgoing instr ent.was acknowledged before m -Al this a day of Au/ 26 Y byz ' this 04rday of--22 V2— -by I ;�m I' A _Z 2C7& (Name of person acknowledging) a (Name of person acknowledging) (Signature of 6(tary Public-State of Florida Florida(Signature of Nota State of - Personally Kn OR Produced Identification Personally Known_OR Produced Identification Type of Identifica on Type of Idenftaqon Produced _A Produced— J35,t. ........dr Commission No. (Sea)) CommissionVO. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED iev.7/201