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HomeMy WebLinkAboutBuilding Permit Application r ALL APPLICABJLE INFO ST BE COMPL ED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: u C�r3 r`fi-e �2scllFiwci n 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 /t PERMIT APPLICATION FOR: To elect from dropbox, click arrow at the end of line ROPOSED IIl�tPROVEME IT LCJC TION. Address: Legal Description: Property Tax ID#: e-?6) 6'61 anaLot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side:_ 7 Left Side: DET,4ILED DECRIPT0. [ON sly ©� Aaditional workto DMrrormea under his permit-check�ail pp y HVAC _Gas Tank Gas Piping Shutters Q Windows/Doors Electric 0 Plumbing Sprinklers FIGenerator g Roof Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ Lltilities:nSewer Septic Building Height: 0KIER�LESSEE ON TRATOF2 Name, Name. All Address: Z' Company: QI`/— l� City: L�/l� 1� �l� ��. ;� Stater Address:�( f'I�+IE L.;�-� �� r-7e Zip Code: Fax: City: �t�.5 eA7 State: >� Phone No-4699-2; _ C6'&C Zip Code: Fax: E-Mail: Phone No. '7_01 16Y Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: If value of construction is$2500 or more,a RE ORDED Notice of Commencement is required. SUPPlENIENT1f:CC!# STRUCTO LIN:...LAW.. 9�t?RfIATICta;.: ,.. DESIGNER/ENGINEER: No Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: No Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: I certify that no work or installation has comi ienced prior to the issuance of a permit_ St.Lucie County makes no representation tha t is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home wners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Nome Ow iers Association and review your deed for any restrictions which may apply. In consideration of the granting of this reque ed permit,i do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,the A rida Building Codes and St.Lucie County Amendments. The following building permit applications ar exempt from undergoing a full concurrency review:room additions, accessorystructures,swimming pools,fences walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to lecord a Notice of Commencement may result in your paying twice for improvements to your property_A No ice of Commencement must be recorded and posted on the jobsite before the first inspection:If you inter d to obtain financing,consult with lender or an attorney before corpyneqerwork or recording our P otice of Commencemen . 14 s _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF c_� 1'Q_ COUNTY OF _ 0-A, The fprping instru nt was acknowledge re me this instru ent was acknowledgeefore me thi day of _, ZO y this day of`. 20 by L tie d (Name of person acknowle ging) (Name rson acknowledgi ) f a Public-State of Florida) (Signature of Not ry ublic-State of Florida) Per OR Produced identification rsonally Known OR Produced Identification Type of identification Produced Type of Identificat n Produced Commission No. (Sea) Commission No. {Seal} Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS