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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INJO MUST E OMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:' �I .- Building Permit Application Planning and Development Services a Building and Code Regulation Division 2300 Virginia Avenue;-Fort Pierce FL 34982- - -- -- Phone: 772 462-1553 Fax: 772 462-1578 Commercial Residential PERMIT APPLICATION FOR: w e Address: 1 6avlaii 0' , IC' ' 1 Legal Description: ! Q I Property Tax ID#: I -'6 L(LIZ ` ©q ®3"l — Lot No. I Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Sider Left Side: a mlJr mcv-1- r_\MOP" rmnk k [- � i Additional work to be performed under this permit—cheCK all tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters ;; _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: J Cost of Construction: Utilities: —Sewer _Septic' I Building Height: i Name 1je- t-V �5� 1 Name: i I i Address: c�`? VL Company: �� d�o,il�i o � P Y: - City: State:,VL _ Address: Zip Code: 3 q L1 laFax: City: State: Phone No. 144 — Zip Code: Fax: 4 • E-Mail: C- Phone No Fill in fee simple Title Holder on next page(if d fevent -wil from the Owner listed above) State or County Licensel i if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.' i I 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: -- City: City: Zip: Phone: Zip:. Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. 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 our Notice of Commencement. Signature of Ow /Lessee/Cont ctor as Agent for Owner Signature of Contractor/License Holder STATE OF FLO IDA ` STATE OF FLORIDA COUNTY OF l n ( COUNTY OF The fro' g instrum t was acknowledged-before me The forgoing instrument was acknowledged-before me this day of 2by this day of ,20_ by Inn (Name of person ackn le ging) (Name of person acknowledging) (Signature of N ary Public-State of Florid ) (Signature of Notary Public-State of Florida) Personally Known Tr 0 ' P uc Id -tification Personally Known OR Produced Identification Type�Gf4d> t t d ANGELA M HUFF Type of Identification Prod cedPaY°'�e 'r-State of Florida Produced =k` ' Commission#FF 234730 Com o »cis My Comm.Expires May 27,DI 1h Commission No. (Seal) q Bonded through National Notary ssn.li —� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE , COMPLETED ev. 7/2014