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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: C `7 Permit Number: 1�d1-oa�6 RE C E!`." JAN 1 7017 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: S >, PROP- E► INPROU MENT OCATION Address: ,s`/G, W:-A OA-/Z_ Legal Description: Property Tax ID#: sol, n d 1'GQ4-1 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front_ Back: Right Side:_ Left Side:_ D ILED ►ffC« P I©' tO ARK S'T712C_. 7 Atf-e— 47� 77YWS CONS RUC ION INFOR A ION• itiona wor to a per Orme 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 Pitch Total Sq. Ft of Construction: - Sq. Ft.of First Floor: Cost of Construction: $ q,416® Utilities: _Sewer _Septic Building Height: COMM N,1 @10E0 SE M. 11COMUffiT11- 1C OR: ;c� c Name �i��'-�.' - ;�' 1' Na': - Address: S2: .. .5/L: ik U/�'/L Corp'pany I,a'o'S'SG� %OL �Gu1✓i= City: P0/2,1 S% G 66,c,11 2 State: Address:—e-ii -h Zip Code: Fax: City:��L ! '= State: p W 9 9 D Fax: Phone No. Zi Code: 3 E-Mail: Phone No ``7 `72- Ro (-- 2- Fill Fill in fee simple Title Holder on next page (if different E-Mail'-//A/F I'b�=,. 8 from the Owner listed above) State or County License 4f 6-C— f ryf value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPL AMENTAL CONSTRUCTION LIEN LAW RHMMMMOO 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 S�-. L ,)c'l,('— COUNTY OF S!� �LUc The forgoing instru ent was acknowled a before me The forgoing instru grit was acknowledged before me this day of �A 20� by this _day of Sal-V� 20D_ by cd► �a►141%Cyl (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary P lic-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identificat' •,..... Produced C- '� �—, Produced : DEMINAMARIEGNENS MARIE G►VENS ;Y N#GG 022023 DcANNA 23 "� EXPIRES: 2020 �{ON#GG 0220 Commission No. ,MYCo ►� Commission No. • - S:D tnbet 16,.2020 Thru Nota P1151�Underwriters •y •pP� gondedPIThMNOtaryPubllcUndetwdters REVIEWS FRO T ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/203.4