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HomeMy WebLinkAboutBuilding Permit Application All APPLICA LE INF p MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t� Date: I Ill I I Permit Number: RECEk,; Building Permit Application Planning and Development Services JAN 18 1017 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: PROPOSED INPR®UEMENT L®CATION: Address: 3&(3 S� 1 l�P-0UGK- Lt l S L E 5 S Legal Description: 'i t�C;� C.��Sc� ?i✓ �''l� s-VA_v--,f-w C'IA.L-L:�, Property Tax ID#: :3 q Z,� 7 D 06 f7_ 6667 Lot No. Site Plan Name: ee-s 1D1D w C-15- Block No. Project Name: Setbacks Front Back: Right Side: • Left Side: DTA DD DEQ C IPTIO' W WORK: CONST U I©N N =TI@N ; Additional work to be performed unclert is permit-cneck all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator Roof Pitch Total Sq. Ft'of Construction: Mao S2�`�`f` Sq. Ft.of First Floor: Cost of Construction: $ S1300 `' Utilities: _Sewer _Septic Building Height: NOUN@R/ ONTRACME, R: Name IVoPCT Amf_>,_Tp_A.NAj6 �Au'fttlefZ Name: Address: 3&13 SPX i G)C- UJ Company: C.S-(75f.SEs�� City: P5 L State: �L Address: `71 /SCS t7 Af�-_ Zip Code: c34 g5-Z Fax: City: 1-'t :BgEq cE State:E�C, Phone No. 77+-&LN 1630 3 Zip Code: z3T K-2_- Fax: E-Mail: Phone No `77Z - Fill in fee simple Title Holder on next page(if different E-Mail W& X e,- ,a-e�- a from the Owner listed above) State or County License /C4C.SLS`_ If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. MP EMENTAL CONSTRUCT®N LIEN LAW INFtORMATI®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 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 i ur paying twice for improvements to y r property. A Notice of Commencement must be record and p steel on the jobsite before the first i on. If you intend to obtain financing, consult with I der or torney before commencin or r r cordin our Notice of Commencement. Sigrl6ure of essee Contractor as Agent for Owner Signa of Contractor/License Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF 5-\- L- ic�-P- COUNTY OF �-�L uC­'rp- The fo ing instru ent was acknowledge�fore me The f oing instr�aent was acknowledged before me this day of 20 L`'!by thisl' day of JQ (� ,20J_7 by C� Cucu--i (N of person acknowledging) (Name of person acknowle ging) (Signature o o lic-State of Florida) (Signature Njata Public-State of FloridaWill ) `� IY �! N111 Personally KnoV� �. �A�" C�iPro u cA lh��iN[ficatio s ti!'n ,\ OR P1%deLC�gt� ary ublic-State of Florida Type of Idenfifiati;- n,' otary public_State of Commission#FF ;r�,ua . Qc Commission Florida �, .oP; _ 234730 Produced �. n+. #F 34730 Produced ' y— - ,,. Bonded through s May 27.2013 "_ Bor;r!edthrou Expires May 19 Assn. gh Nati 9 National A Commission No. YAssn. Commission No. �= sn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/21014