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HomeMy WebLinkAboutBuilding Permit Application e � _ All APPLICABLE INFOI MUST BE COMF zr ,.ED FOR APPLICATION TO BE ACCEPTED ` Date: �,\Cl'� �6(� Permit Number: 1070 )- 0 3LA s .v RECEIVE® T B 51 ,g ' Building Permit Application JAN 2 0 2017 }~ Planning and Development Services Building and Code Regulation.'Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1I 553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: I PROP®SED INPROUEM'EIS,T LOCATIC?'N: Address: `IEA 'c gK FL Vv '34Q2 Legal Description: CI`vC_?, 121 i\,C: RS&Mr_- MA%V=- 3!M A% f no- i Property Tax ID#: ZA?1�5 o 'T4s Coe'?-- (368 0 6 Lot No. Qk� Site Plan Name: 1 Block No. Co� ProjectName: Setbacks Front Back: Right Side: Left Side: I DETAILED DE�SCR+IPTION OF WORK: NMI 9RtA0uCC 'eXjks-Z JUL S�&j"LL1; Z au)N beg LWY %,jcL Up W CONSTRUCTION INF©R+NATION: Adclitional work to Pe pertormed uncler this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _/Windows/Doors �, ! _Electric _Plumbing —Sprinklers _Generator J, Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: r Cost of Construction: $ to,J16, Q U .._ ,..,____Utilities: _Sewer _Septic Building Height: ODUNERLE=�S�SEE: I Al CON iiRCOR: Name L SROL�*t� Name: GlEL�S clJ Address: Company: s, e6:6isr kr.1C City: St. Liz_tz- State:IFLI�& Address: kc:;�V% UE C=)�,QDWt L QVC Zip Code:?AkqZ Fax: City: State:State:FLA Phone No. -7T?- R`74`7 Zip Code:;& Fax: -T'TfQZ4?__461L E-Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mai.l from the Owner listed above) State or County License j=c- If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. StJ!PP�EME'NT 6L C®NSl'R;UC I®'N LIEN LAUV I FORMATIOf 6 r, 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: I Name: ,]w Address:_ Address: tj Ila 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 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 can Lessee/Agent Signature of Contras or/License Holder STATE OF FLORIDA ) STATE OF FLORIDA. COUNTY OF !//� COUNTY OF The forgoing instrument was acknowledged before me The forgoing instru nt was acknowledged before me this day of 20/) by this day of 20,4)by L� (Nam person icknowledging) (Name acknow ed (Signature of otary Public-State of Florida) (Si ature a Public-State f FI ida) Pern own Identification Pers p �w7�rs�wn OYHERto uce Identification `" SSION#FF Typ rsfic�>I�IdMISSION A FF92084o Typ ' S:Nova Pro EXPIRES:November 18,2019 Pro CSB} : ' eon mbar 18,2019 'R`•,••` u k Undervrtiters ers Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.