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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE I FOM ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ��« Permit Number: 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'R®P®SED NPR©UEMEN LOCATION: Address: tfff Y1on <Z�V. 39q?,-2_ Legal Description: Property Tax ID#: a'A 11 70k Lot No. Site Plan Name: Si- Block No. Project Name: d� 1/ er 1 /Y Setbacks Front Back: = Right Side: Left Side: DE AILED DE�SC + ' ON © ORK: 2�F qtr—_0A.1 IL . IAC-,N►oy A u. S „AX)L E !t SRE-a A(U o 9LeLMc.6 AN4 2_mEmi LOWD, 2eeukc. CAU..SW-Z-,T Pr JQ 68406 LE I CANS RUCT 0' N "OR ATION: A'Mftionai work to be performed un er t is permit-c ec a tat appy: —Mechanical —Gas Tank —Gas Piping —Shutters _Windows/Doors Electric Plumbing —Sprinklers Generator ✓Roof Total Sq. Ft o Constru ion: �Z 54 Sq. Ft.of First Floor: Cost of Construction: $ Jjya,2oo Utilities: —Sewer _Septic . Building Height: -10 4el OtNN[ER/LENSE CONTR T► R Name e )CCI6a l`_'M2— Name: Address: `3ZyC7 yeY',cl.Qn Company: City: ��r* Pve,I-Ce State: 1I;:;L 'Address: Zip Code: �`I aS"Z, Fax: City: State: Phone No.-78kv -�_�,o?Z�1 Zip Code: Fax: E-Mail: No Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State o ounty License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. rk wAL CONSTR CTI • N U INF®0MA • 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 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: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 our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 2 day of 0-e_C eAe1he,i,— ,20,E by this day of ,20_ by (Name of person acknowledging) (Name of person acknowledging) c ....swlul9f, ma ) (Signature of Notary Public-Stag FIdAR// .-_ (Signature of Notary Public-State of Florida) Personally Known P odu�ced Id ntifjcatFvn Personally Known OR Produced Identification Type of Identification . My comm.Expires: Type of Identification Produced = February 10,2M7 % = roducedp M HUFF s No. — state of FlorlO N•. Q. , Notary Public- 23x730 Commission No. '., pVg( ��)�\Q`�� ommission o. _ * •y �ommisslo(<6aY 27 201 '°r CExP / omm. ''��4�•0F REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETA ._ SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE 10 RECEIVED DATE COMPLETED ev. /2014