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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ` A 1 (�} Permit Number: 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 11 - PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED 1 IMPROVEMENT LOCATION: � L— Address: (t • Va '4 ( )) _ Is Legal Description, Property Tax ID #: V. 'll -?5.1�•' Site Plan Name: \fC Project Name: "Uli U Setbacks Front Back: Right Side: DETAILED DESCRIPTION OF WORK: Left Side: Lot No. a Block No. 0 CONSTRUCTION INFORMATION: Additional work to be performed under this permit — check all tuat apply: VAC L =i Gas Tank E]Gas Piping Shutters ❑ Windows/Doors 11 Electric � Plumbing Sprinklers � Generator � Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ Lf-4ck)_c,(D OWNER/LESSEE: S Ft. of FirstFloor:Floor: Utilities: Sewer L �l Septic Building Height: Name [ i CTti ```_ SQL C"- Addre 0 [ �, Cit : k- �. >1(.�._ State: Y Zip Code: �j l Fax: Phone No E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Name: S4 - Company: 3yti.:..4\r' Address- city ddress: {t City, i„{ 1\, t StateE_ Zip Code: �`��llvb FaxGlGl(y! Phone No.^ -� E-Mail:,nC►.��,�tAr}�.`�, State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: Stater 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 recording your Notice of Commencement. s _ Signature of Owner/ L e ge t Signature of ContracZA older f�. STATE OF FLORI A STATE OF FLO COUNTY OFCOUNTY OF The "I aing instrument was acknowledged before me The forgoing instrument was acknowledged before me thisa day of�IVN" , 20\%by this \A_ day of tA►fwr\ , 20 i)__ by (Name .,Rers_on acknowledging) N .,,e of person acknowledging ) �(Signatu of tary Public- State o Florida) (Sign ureNf Notary Public- Stat of Florida ) Personally Known L ---'-&-R Produced Identification Personally Known Produced Identification Type of Identification Produced Type of Identification ' Identificcaatiion Produce'd�•,, YEIIGCommission No. immission No` 41Htl [ S DMI rt FF SDM�10NAFFD0 83006 •. 25, 20 EXPIRES: April 18 s EXPIRES: Apnl 25, 2018 p Bond©d Thru Nola Public Undenurilers Rn ' r� ry w lo- 'r . , • : _-++�..-.-..._. Revised 07/15/2014 REVIEWS FRONT ZONING COUNTER REVIEW DATE COMPLETE INITIALS SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW