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HomeMy WebLinkAboutBuilding Permit ApplictionALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 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 PERMIT APPLICATION FOR: To SeIeG1 from dropbox, click arrow at the end of line PROPOSED II PROVEM Address: IV I fJ 0 UJ 11-.b OWE Legal Description: Property Tax ID #: 4 qa- 915- co - 633y g Lot No. Site Plan Name: Block No, Project Name: Setbacks Front Back: Right Side: Left Side: TAILED DESC RIPT !ON" 0E-WOR'K._.:�.,: P,E- PLACF- CONSTRUCTI ffl 72. A ON Afirlifinnni wnrk- to hp nPrTnrmsad i3ridtar thic narm&- rharLe 211 th�?* nnniv- 11HVAC Gas Tank ElGas Piping 9 Electric Plumbing OSprinklers Total Sq. Ft of Construction: Cost of Construction: Shutters 11 Windows/Doors Generator L1 Roof SQ. Ft. of First Floor: Utilities: R Sewer Sep—tic Address: 144 I VJ WLJ> 00Vr'-' C_r City: Efyvv\ CITY State: FL Zip Code- 3q9 10 — Fax: Phone No. E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Building Height; Name: A?, -Wok IEVC-6(_MAIVN Company: ftURA1_6 &F_MCA-1 &&T-1AAC1_1A1rJA Address: '703 &Z1101TI P_ city: (0)1t: -r -1;7- I-or-fe- State: rl_ Zip Code: Fax: Phone No. E -Mail: r) C V'"ri Q q P, A-1 hi F_ T, State or County License: EC 000 30-7 -L If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. Name: — .. Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: ,Not Applicable Name: _ Address: City:_ 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 thepermit 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 5t. 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 comment iAR work,0recording your Notice of Commencement. .) Rev. 1/2IJ14 Signa re of Holder Sign re' of D er/ Agent/ Lessee STATE OF FLORII]A Zonactor/License 5TATE OF ID COUNTY OF -:i/ c? Lfi ;f COUNTY OF &4e t The forgoing instru ent a �Cnowledged before me / The for ping instru nt as a . 4nowledged before me this day of 2t71 by this day of 2aJ by {Name of person ackno ging } {Name of person ac edging ) (Signature of Notary Public- Staff of Florida) (Signature of Notary Public- StgCe of Florida ) i111ilI n Personally Known O.OR Pro 0e1pI!j�� Personally Known �OR Produced Identification Type of Identification Produced d��' "+*. "ri Type of Identification Produced J1111lll 11/ • �© berF moi--'-- Commission No. r'��` (5ealjp�,rni �_ y ,r Commission No. + �, aN '•• ' • �a°' ^3 rir s2 #FF M192 Q� , * _ REVIEWS FRONTr�'�u ice' 46 handed .....COUNTER VISOR PLANS VEGETATION ` SiiRTL "tilVE R SfA��irt�1/1EW REVIEW REVIEWR DATE ��'rrtrf�ilrr6 +�����`�!• RECEIVED DATE COMPLETED Rev. 1/2IJ14