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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED –1 Date: Permit Number: RECEI �r APR 2 8 ?,017 a �� Building Permit Application 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: To Select from dropbox, click arrow at the end of line P,� P�,tOsiP©SED ER!ENT L®CATt®N: Address: 900 'M impLoir df D�?bye_ Oo i+ 0 Legal Description: Property Tax ID#: ��of 5 V0 �—a0��-�a�" s Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 'DETAI'LED DEASC JPTfON ®F WORK.: _7ns-�alr? -'Pn,-f�y 09 /hear Pee+ ( -rr4 hrg1� .2 C?0 k,5, ICON-ST +UCTiION fNFORII®:N: Additional work toe performed under tis permit–ch,cl all fn appy: HVAC Gas Tank E]Gas Piping _Shutters .Windows/Doors 11Electric ElPlumbingSprinklers ❑Generator [:] Roof' Roof +� Roof pitch Total Sq. Ft of Construction: SFt.of First Floor: Du ' Cost of Construction:$��00 Utilities: _Sewer 1:1 Septic Building Height: OWNER/LOSTROMC®NTRACT®R: Name 85&-r (1f9RL.UGC- Name: Address:- QU 6 shO(P Wl'a G(S D2Ot74 Company:.; City: U1 HI)frk1f(a)o _ c)9r1Y Stater Address: Zip Code: Fax: // City:. State: Phone No. -5101'3Qy—V aI T Zip Code: Fax: E-Mail: K/9T•5V1S1iA) C' (36I.Ic n'1 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. SUPPLEMENTAL CONSTRUCTI©NII IEN LAW INF®RMATf®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:ro6im 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 c9,9Mencingor recording our Notice of Commencement. s 'Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA L�c�� STATE OY FLORIDA COUNTY OF S� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me thisa0 day of A 0y�1 q 20 by this_day of 20 _by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pub't-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced 1Q L Type of Identification Produced Commission No. S Commission No. (Seal) r _,.........,; DEANNA ARIEGry0 MY COMMISSION#GG 02202 I '�� oP+ BondedPThN Notary Public UndeTwdters Revised 07/15/20 •,;�;; .•• � REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS