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HomeMy WebLinkAboutOVERNALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Budding 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 uzz PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT Li7CATION: Address: Legal Description: I l i l AS- 3Z 1611) Un'l t� 3 c►� I,. C� N D �6-rLctcl. JS �)- q Cq ) - Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side:. DETAILED DESCRIPTION Of WORK: L K_� Lot No. Block No_ CONSTRUCTION INFORMATION: - A iti na work to e e orme un er t is permit- c ec r a �appt,,9HVAC Gas Tank ©Gas Piping LJ Electric Plumbing 05prinkiers ers0 Windows/Doors MGenerator Roof Roof pitch Total Sq. Ft of Construction: S . Ft. of First Floor: Cost of Construction: $ -`� Utilities: J`�J Sewer I =I Septic Building Height; OWNER/LESSEE: .CONTRACTOR: Name _ C� (-on a C),V L Name: CeT2a —r Address: oc-e-Qn D (k, 4 3-23 Company:—r q City: '� 1 t t'22—elt- h � State: F- �`-t �'I Address: 'V L I3 C)Y- C-ko o Zip Code: Fax: Phone No. City: �e-E n-jec,-Ei1 State: -F -(- Zip Code: 2)Aq4 5� Fax: E -Mail: PhoneNo. Fill in fee simple Title Holder on next page ( if different E -Mail: T ] ' C) C:,I) -AST f�4E-T from the Owner listed above) State or County License: If value of construction is $25DD or more, a RECORDEiD Notice of Commencement is required. SUPPLEMENTAL CONSTRUCT{'QN LIEN LAUV INE DESIGNER/ENGINEER: Not Applicable Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: zip: Phone: ,TION: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Name: _ Address: City:_ Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. Not Applicable 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 our Notice of Commencement. Sign`at a of Oner/Lessee/Contractor as Agent for Owner Sig tore o ntractorf License Holder s STATE OF FLORIDA STATE OF FLORIDA COUNTY OF v�� { I' 1. a COUNTY OF The forgping instrument was acknowledged before me The forgoing instrument was acknowledged before me this 3'� Ilday of lk� t 20 by this I day of Biu 20 F7 by (Name of person acknowledging) (Name of person acknowledging) (Signature o tary Public- State of Florida) (Signature otary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification Commission No. '; " Comrrl�sesn # GG 62174 My Caamm'`i'Jsssion Expires *��January 14, 2021 NOUN Revised 07115/2014 REVIEWS FRONT ZONING SUPERVISOR COUNTER REVIEW REVIEW COMPLETE INITIALS Personally Known i� OR Produced Identification Type of Identificati­A — — - - - JOY POLLARD Commission No. '•° = Commissit8&A)G 62174 =., My Commission Expires 's*ti Of ;,�''' January 14, 2021 PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW