Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: % Permit Number: RECEIVED SEP 2 9 2017 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: 't t1C P QPOSEgqD IN ' ROVEMENT LOCATIC} : Address: `S 5 d eve h Legal Description: Property Tax ID#: �. 1 a 5 -161- C)CS 6 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back:• Right Side: Left Side: DETAILEDDE=! R+I�PTIKN QF WORK; CONS RUC t N 'NFORMATION: Add itiona wor to a pe orme un er t is permit–.c ec a 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: Cost of Construction:$ 0�0(� , ('� Utilities: —*Sewer. _Septic Building Height: OWNEOR,LE=�S� �E: CONTRACTOR: Name C1.W1�. Name: Address: 3.50 (o AVOLY1 uC Company:" City: !_ay.1_ 9;-P r --C State:'�� Address:_-:. Zip Code: 3CI q L4 9 Fax: City: State: Phone No. 3k'R .Le13 `0_7©0 Zip Code: Fax: E-Mail: J rn Si 7h!) 19 q10 YG-. 00, CO rn Phone No 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 RECORDED Notice of Commencement is required. SU .'Pd'JEggll NSTRLfifflI©NOME LAW IN�FO'R+MAT10 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: 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 Countyy 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. � aimzo Q . Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this',°-day of Sa ,p A 20\1 by this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced �- 01 Produced (Signature of Notary Pu -State of 411r� T (Signature of Notary Public-State of Florida) ........,.i DEANNA MARIE GIVENS Commission No. If4%At C0MMIS )GG022023 Commission No. (Seal) o` EXPIRES:December 16,2020 '%rF•••••o:� BondedThNNotaryPublic Undenxriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17