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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: S-- 8- 17 Permit Number: I���' 01(0 to HeM � . 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 PRO PR DOSED,IMOVtM' tNT LOCATION Address: 110 1,_qea 'j-' iV �r -0/e;c e Y19 Legal Description: e r-e� -71Gh _7' GhP. 2 024 Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORI< , r. , y.. b 0 o t- T-e_Fl Qce)-Y to 4 Remit ove �h r�p� �xJ- r i c), lb©D,v-S c-nd Fr'QrreS CQNSTRUCTION,fNFORMAI"ION R. Additionalwork to be nertormed under t isermit-check p all apply: HVAC Gas Tank Gas Piping _Shutters Q Windows Doors Electric ❑ Plumbing Sprinklers E Generator 1:1 Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: a Cost of Construction: $ c' ®© Utilities: _Sewer ElSeptic Building Height: .OWNER LE! CONTRACTOR,i� .' Name ..� O �/ Name: Address: !'/U Company: �7l?Se_ � City:G� �= - State: Address:t SD611,k-Ter C D Zip Code: Fax: City: r4S'4 L.c c State:LL Phone NoZip Code:c3?/9 6?7 Fax:72Z q6 4(a VQ / E-Mail: Phone N .7-72_ ' �� ay6y Fill in fee simple Title Holder on next page ( if different E-Mail 'w7i fC&_010-t4 C do, G from the Owner listed above) State or County License: C�j 3 9 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. PPV SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ' 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 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 recor in our Notice of Commencement. s rATE ture o Ow r essee/C ctor as Agent forOwner S' ature o Con actor/License Holder OF FLORIDA ATE OF FLORIDA COUNTY OFCOUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of M0. ,, , 20 n-by this __3 day of , 24�by (Name o erson acknowledging) (Name of rson acknowledging) ignature of Notary Public-St of Florida) (Signature of Notary Public-State f Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification TVU of Identification Produced Type of Identification Produced , 330,0 lig�Arn Commission No. (S.eaIJ � �` Com ssion No. LAS N '�""�"" } �ktate ot.Flotida LASHAHNA INGR M a rue., Notary PUN; tar Public-State o Florida ' ;, , �, Damm.Expires Dec 207 A9 ?; Comm.Expires ; s oQ� Gommtss� s N Notary Revised 07/15/2014 My Commission#FF 177249 %^9:F throa9t ational csn.t o.`, Bonded h National Notary A. ;oFF,r Bonded t REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS