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HomeMy WebLinkAboutBuilding Permit ApplictionALL APPUCABLrJINFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r Date: / �% / % Permit Number: Building Permit Application Planning and Development Services Building and Cade Regulation Division ` 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772) 462-1578 CbmmcrCiai Residential PERMIT APPLICATION FOR: To Select from dropb.ox, click here PROPOSED 1NPROVEMENT LOCATION, Address:. .L��tf .` �or_f �%e/C� 1�� 1-34 9d'' Legal Description: Ail vel/ t e, t1 adi 74 6-1c,(4) PropertyTax ID #:�p - %� Z �` �' � !� Lot No. `,, Site Plan Name: Block No. 4 Project Name: Setbacks Front Back: Right Side: Left Side: `DETAiLEUDESCRIPTION OF WORK: -A/- like 17 e go I CONSTRUCTION iNFORMATION: ! Additional workto be ertormed under this permit- check al that apply: {� HVAC Cas Tank ❑Gas Piping _ Shutters Windows/Doors L� 11 Electric Plumbing OSprinklers 11 Generator Roof Total Sq. Ft of Construction: S Ft, of First Floor: Cost of Construction: $ f . �7 U • ��- Utilities: 11 Sewer L....J Septic Building Height: OWNE/R LESSEE, Name Address: City, �", �'/� State: 6 Zip Code: ''I��� Fax: Phone No. E -Mail: Fill in fee simple Title Holder on next page ( If different from the Owner listed above) CONTRACTOR: N:,me: D©n/ tiT rk�nllaA Ccrnpany: I -i e—+Ao"Ps -�- /lam C'ia�Z Ac dress: 75-6 nit.) /4 ifAP,2r5E DRI Ciiy: %T04�- State: FL Zic Code: Fax: 77a 1 E -Mail: r1(YIC(�CXh(�>1 �'t1'lii�,[�G�C f1t Amt �S, State or County License: Cl -:ice 14Z rW_2 q k dm If value of construction is $2500 or more, a RECORDED Notice of Com_tiencement is required. 0 DESIGNER/ENGINeER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Na me: Address: Ad dress: City: State: City: State: Zip: Phone: Zi Phone: FEE SIMPLE TITLE HOLT ER: Not Applicable RI LADING COMPANY: Not Applicable pp Name: ._ - Na ane: Address: Address: City: Cite: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuar ice of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which Is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and revim your deed for any restrictions which may apply.. In consideration of the granting of this requested permit, I do hereby a;;ree that I will, In all respects, perform the work in accordance with the approved plans, the Florida Building Codes and it. Lucie County Amendments. The following building permit applications are exempt from undergoina full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooX and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Corimencement may result In your paying twice for improvements to your property, A Notice of Commencernait must be recorded and posted on the jobsite before a first ins ection. If you intend to obtain financing, consu e n attorney before co -W enc r < or recor i ur Notice of Commence _ _ s Signature of Owner/ Lessee/Agent L, Signature of Contactor/License Ho der""--.- STATE OF FLORI A Q '9 5 2r � ST TE OF FLORID COUNTY OF �, . �,r" "k e- 5 CO1JNTY OF IvyIt The fgr$a" g instrum�t as acknowledged before r J a ' `" The €ore 'ng instru t as acknowledged before rn �- this der y of \J.1L. U 20 by this Zf by of � . .20 17 by - re's � r� „3,11,, j E c - a (Name f person acknowle ing)O. (Na e ofon acknowledging)— Ors Signature of Noiary Public- State of Florida) ( nature of Ni5iaPublic- State of Florida) �~ f jflltilt'� Personally Known I✓ OR Produced Identification Per -anally Known C✓� oR Produced Identification "type of Identification Produced Typja of Identification Produced p Commission No./-` I (Seal) Commission No.(Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PL NS COUNTER REVIEW REVIEW RE IEW DATE - COMPLETE INITIALS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW