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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 2• Permit Number: Building Permit Application APR 2 6 2@1-t Planning and Development Services PEMCA 1771NG Building and Code Regulation Division St. Lucie Ca nty, FI_ 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IIVIPROVEMENT.LOCAT�I,�ON�: ",. Address: (0 3 �. .8 e,4-GtA A TC _ �F.L 3`t�S Legal Description: Property Tax ID#: 14 6 Q Lot No. 5 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED�DESRP�TlO _ •OF 940 R: CONST�RUCT,ION IN;FORMATIOIV Additional work toe nertormed unclell permit-c ec a appy: HVAC Gas Tank []Gas Piping _Shutters Windows/Doors Electric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction:$ j c9� Utilities:-Sewer Septic Building Height: ®UIl�NER/LES.SEE�• `'� � �®NTR�A�C�TO;R�: Name �''IPr13,`fAJtJ aAh-fie Name: t a Address: 1,03 t�1 Awe Company: City: State: Address: /Yll I., Zip Code: 3-f TI Fax: City: &�4_ State47- Phone No. 5�1 ^ �_Sl ^ 6 8?a- Zip Code: YI J4 Fax: E-Mail: 1091 6 `t ('' tMili— •Q-L",N Phone No. d Uv— a��t�s� 3.1@ Fill in fee simple Title Holder on next page(if different E-Mail: fY�t'-I from the Owner listed above) Stat or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INf®RIVIATI©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: 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 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. —A a—, ja—"� S Signat re of O ner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA ' . ` STATE OF FLORIDA COUNTY OF LUG1-r. COUNTY OF The forgoing instrIlment was acknowledged before me The forgoing instrument was acknowledged before me this M day of 20 a. y this day of 20 _by F1,R 1,LL (Name of per o acknowledging (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 11. I Type of Identification Produced Commission No. ;pR "aJ �r ) KAREN S. NIE� lryllissi n No. (Seal) e * Commission # F 115637 N a= My Commission Expires June 12, 2018 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS I -