Loading...
HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: � Date: —aai i 44 114 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: Address: Legal De'. Property Tax lD #: 9LAalX __1 Site Plan Name: Project Name: Setbacks Front Back: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: UHVAC ILI''J''II Gas Tank Electric EJ Plumbing Total Sq. Ft of Construction: s r.. ,,nhn < jyhq Lot No.-YIV_ Block No. Right Side: Left Side: «.o CONTRACTOR: Name: ire (dY✓ [3Windows/Doors Piping L_J Shutters f a e (7@•iit°� e4larz ❑ Generator 13 Roof _SqI FFtt.I of First Floor: Utilities: L�Sewer 1:1 Septic Building Height: OWNER/LESSEE: Name &2Cqp .' u /I CONTRACTOR: Name: ire (dY✓ Company: trio Address: 01 SaKIRAG C.ir _ 'i/ Address: f a e (7@•iit°� Pi)`It�rr�� City: R7rir- �G1n� �-!.cit. —Stater Zip Code: 210.1 Fax: Phone No. % 2 2 - 571 -X421 City: Fax: Zip Code:*r'mo�mu� Phone NoFill S[a[e:�f 1 Oyz E -Mail: E-Mail:�Feto/ F�'n In fee simple Title Holder on next page ( if different from the owner listed above) State or County License: I........r.e. IL value orconsarucumI niaaw �•^•�•_• ••^—"--'---'--- - -- 61111"11 m wnr ©aepucer%e newer STATE OF FLORIDA I S STATE OF FLOR A COUNTY OF '�, '�j 1 J COUNTY OF The S The f going instr en s acknowledgea before me this�Qday of t 20 by Type of Identific Commission No. Revised 07/15/2014 y,. �'. �(SL��r OMM!SSJp' drFFi a•�. �?' EXPIRES May 7.: The fog Bping instruument�w s acknowledged before me this J.� day of 'lf f3f 20= by acknowledging of Notary Public- State of Florea ) KnownOR Produced Identify .ntifcatlo Pro used n No. (Seal) FRONT COUNTER SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 SONDINGCOMPANY: Not Applicable Name: Name: Address: 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. work or Installation has commenced prior to the Issuance of a permit. I certify that nun St.too is,, conFll t with any no applicable Home aOwners Associipermit rules, bylaws othe and covenants that may prohibit such restrict of 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 the Florida Building plans, 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 ins ection. If y intend to obtain financing, consult withlender or an attorney before commencingA r reco . our Notice of Commencement. vq l� /j �'/y SI t f(hu , - -- 61111"11 m wnr ©aepucer%e newer STATE OF FLORIDA I S STATE OF FLOR A COUNTY OF '�, '�j 1 J COUNTY OF The S The f going instr en s acknowledgea before me this�Qday of t 20 by Type of Identific Commission No. Revised 07/15/2014 y,. �'. �(SL��r OMM!SSJp' drFFi a•�. �?' EXPIRES May 7.: The fog Bping instruument�w s acknowledged before me this J.� day of 'lf f3f 20= by acknowledging of Notary Public- State of Florea ) KnownOR Produced Identify .ntifcatlo Pro used n No. (Seal) FRONT COUNTER IL