Loading...
HomeMy WebLinkAboutBuilding Permit Application EED All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE PeCmiPtTNumber: Date: l.� RECEIVE. Building Permit Application FEB 10 2017" 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: 3 --elnl) J)L e PROP®SED INPR,Ol/EMENT`LOCtON; Address: Legal Description: Property Tax ID#: "'lL' o'�_ —�f.'©' Lot No. Site Plan Name: f y� Block No. Project Name: C-3 Setbacks Front Back: Right Side:��Left Side: DETAILED DE�S:CR°�PTIO' OF 1N�®R�K: is /L ' �lordeZ lox /� E°Z�� � ff NO R CO'NS�TRa CTGO'N I N�FOR�IV�ATIO N-: _ Additional work-Wo be pertormed under this permit—check all that appy: _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:$ ��6 U Utilities: _Sewer _Septic Building Height: OWN�R�a jE: CO: TR� CTOR; Name Name: Address: / Company: City: 0 AAft Stat :2 Address: Zip Code: KM Fax: City: State: Phone No.d 2— D"T0,3 Zip Code: Fax: E-Mail: � � .?-2� . I�'1C�1�N Phone No Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SIJPF'LEMENTAL C®'NSTRUCTION LIEN LAW INF®RIUTATI®N: DESIGNE ENGINEER: No Applicable MORTGAGE COMPANY: _Not Applicable Name. C is &4)gTAT L e: Address:.° [ !�i ,t0 T Address: City:<,> State:' City: State: Zip: Phoneme 4 _-S,5P— 2 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�our property. A Notice of Commencement must be recorded and posted on the jobsite before the fir inn. f you intend to obtain financing, consult with lender or an attorney before commenc' wor di our Notice of Commencement. �aS' at` o- ner/ es a ontrac oras Agent for Owner Signature of Contractor/License Holder ATE OF FLORID - STATE OF FLORIDA COUNTY OF _�f/ COUNTY OF The forgoing instrum t was acknowledge?efo mft The forgoing instrument was acknowledged before me this i ri day of 20� by W�o this day of , 20_ by 2�N v 0 ca Z (Name of person acknowledging) ?oa 2 (Name of person acknowledging) rw v � a 0 m (Signature of-Notary Public-State of Florida) (Signature of tary Public-State of FI ida] r Personally KnoNfnL OR Produced Identifi �e 't'' Personally Known OR Produced Identification Type of Identificati l Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.