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HomeMy WebLinkAboutBuilding Permit Application All APPLICA III 11�F M S BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 Permit Number: I 3 � VAJ 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: PROPOSEI1D INPR®�E�ME\yiNT LOCATION: Address: DI O Q3 `\ 1 Legal Description: PropertyTax ID#: ©0© Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILEDI®E;SCRI,PTI®N OF WORK: 7,-K{3 ,Q�M-y) o CQNSTRUCTION N'F®R� ATION: Adclitional work to be performed under this permit—check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric ZG.Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Cdnstruction' Sq. Ft.of First,Floor: . Costof Construction:$ &0?31Z QC) Utilities:. _Sewer _Septic Building Height:' 01NNER/LESSEE: C®N,LTLR6TAATCTOR: Name +;Zoe Name:Z rVN S(z0z o Address:alO6 1\� 'k_� ST Company: ROSSOON1 , 4a PLur- 3i 0-J City:V—\ Q��n,�, State: C. Address: 9P, 20-,4 �1121 Zip Code: 3 L\ C) Fax: City:Pose S-s Ll C 1 ic State Phone No. `1'7�-5C>) S Zip Code: 3L) ) 2_5 Fax: E-Mail: Phone No �1)J �.,),g,- �9?,R-2 Fill in fee simple Title Holder on next page (if different E-Mail +j-)t mZ L9rh= P2 c) m Y19NDO $ Co7YJ from the Owner listed above) State or County License C F C I If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. UIVPP EM'ENTAL C®NSTR.UCTI®N LIEN LAW INF®RMATI9. 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 our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF L" COUNTY OF The TI— ay o instru a wa acknowled a efore me The fpr ing instr me s acknowledgMy fore me this of 20 y this 1 day of 20 O)e—X-� u ` (Name of person acknowledging) (N a of person acknowledging) (Signature of N ry Pub tc-State of Florida) (Signature QN ubl',--State of Florida) tP Yp`/ Personal) Y`ro. �`�= Nott 11 AN�EdI eco WBrentitica ion Personally Known r €� Ica lo' Id _ c oSQc-state of Florida Type of Identi' Yp"a�,� Type of ,,l �o; M m ission#FF *�; No ar Public-State of Florida produced Y o 234730 Produced =. •_ FF 2347307.2019 My Comm.Expires May 27,2012,' Bonded through NationalNot „OF F��,� tCommission No. h - Commission Bonded through Natitgb)aryAssn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 112014