Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:_5- 1 Permit Number: RECEIVED MAY 10 2017 Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce F134982 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 IMPROVEMENT-LOCATION: Address: 0903 V ic_K osan Legal Description: ©(ep„ (Zo p`4,-r LSU- _' 1 L-0 T 5-] Property Tax lD#: '�41 S - -7'b 6 - 00 Z S - boo- 2 Lot No. 1 S� Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF.WORK: Chav 4b CONSTRUCTION INFORMATION: Additional work to be Dertormed under this permit-check a appy: HVAC LJ Gas Tank E]Gas Piping _Shutters Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ ( (0d CX) Utilities:�Sewer Septic Building Height: -OWNER/LESSEE: CONTRACTOR: Name &WTIJJ c'� Name: w Address: cl4 i nSon U-r Company: Cr eA-+—� C City: �p •Sr1. State: Address: ZGIS D CjL (Zv Zip Code: 34'►S2 Fax: City: -P'S•t-• 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 or County License: CG:C O SS87Z If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIfN1AW 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 woft or recording our Notice of Commencement. s Signature of Owner/L ss a ontractor as Agent for Owner Signature of Cont act Licen older STATE OF FLORIDA STATE OF FLORI COUNTY OF 12?144_-7 ) <-1• COUNTY OF Oz'!/�✓Lys The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20/-?by this_Qday of 20 L:�_by (Name of person acknowledging) (Name of person acknowledging) Sabina Jaduslngh A )Q, Sabina Jadusingh (Signature of Notary P blic- ate of Florida) (Signature of Nott P lic-State of Florida) Personally Known OR Produced Id n 'fication Personally Known OR Produced Identifi ation Type of Identification Produced t7 I dope of Identification Produced ��-��� Commission No. NOTARY PUBLIC ommission No. N TARY PUBLIC STATE OF FLORI AC TE OF FLORIDA Comm#FF107045 Comm#FF107045 res 711912018 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS