Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � r Permit Number: I t O c1liq CF Building Permit Application � mW ED Planning Development Services Plan gnad Dev e p FEB 13 2092 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 PER.MlTT Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resider*igcie bdunty, FL PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PRf)PQSED I.MPR®1/E,�MENT' LOaCA�TI�(3Nt; ° Address: Legal Description: Property Tax ID#: l Lot No. Site Plan Name: Block No. Project Name: Setbacks- Front Back: Right Side: Left Side: DET�AIL.ED DES�CRI�PTI®N ®F WORK:. ` x� IMS( 1Ao1,3 St... 2-SOo °nC,ci L � J .-Rb C®�NS�TRUCTI:QIU IN!F®RM�TI®�Nc . Additional work toe .er orme under this permit—check a appy: HVAC Ei Gas Tank ❑Gas Piping _Shutters a Windows/Doors Electric ❑_Plumbing Sprinklers ❑Generator Roof Roof pitch Total Sq. Ft of Construct n: © S . Ft.of First Floor: 33. Cost of Construction:$ Utilities: _Sewer E]Septic Building Height: ®UVN�E /LESSEE: C®:NT`RACT®R: j Name /4S `rl5ion — �Cc7/1A�� ---*S� Name: Address: N-0 S S`� Company: City: f k p\ Q fC -� State:;��. 'Address: Zip Code:3 Fax: City: = State: Phone No © Zip Code:—, Fax: E-Mail: Phone No. Fill in fee simple Title Holder on next page-(if different E-Mail: from the Owner listed above) State County License: If value of construction is$2500 or more,a RECORDED Notice of mmencement is required. S;U4PPI.EME;NTAL CONS�T, I2iU =l1yOaN�LIEN LAWINF®FtMATIOfv »{RTa <' : •"_a5:.. . r. imx'�R XSi'$i.w;..,,.. �. m'I.:Mv%£'._.i Nv7s f R DESIGNER/ NGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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. C[ S;6 A Oto-)vil t s . Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORSTATE OF FLORIDA COUNTY OF� LI (t)d COUNTY OF The forgoing instru t was acknowledged-igefore me The forgoing instrument was acknowledged before me this Iva day of 20 by by this day of 20 by (Name of person acknowle ing) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced )�] Type of Identification Produced Commission No. ?;ar"tel) KAREN S. NIEL��"mi 'on No. (Seal) c _Commission t# FF 115637 J. ._ o= My Commission xpires ''�pinn1�a` 12, Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE ,a COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS