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HomeMy WebLinkAboutBuilding Permit Application h ALL APPLI ABLE I FOUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1117 - Date. f Permit Number: 'I 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 Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMEN 3„ T LOCATION Address: �©"� F r Di C�a,. 0�`a —Y, [fie i`e- �� I 7�93 Legal Description: P'i Ver 4 k- (.0 n i-r / Property Tax ID#: 3 100.4-V e 600 " I) Lot No. Site Plan Name: Y— Block No. Project Name: Setbacks Front Back: Right Side: Left Side: I I DETAILED DESCRIPTION OF WORK ii �I CONSTRUCTION INFORMATION �. Additional workto e e orme un er is permit-c he.T-50 appy: 'I HVAC Gas Tank []Gas Piping _Shutters 4 Windows/Doors Electric 0 Plumbing FISprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor: �I Cost of Construction;$ l�©C7. ®b Utilities: Sewer Septic i Building Height: bW1N.ER/,LESSEE ;CONTRACT.OR;` ! Name uo Name: V . Address: /DC/ .Gtr Company: it City:- � r_4 �e;f State: Address* 8l 7 ` ` t ✓e. Zip Code: -3 9U Fax: City: / ai Stater Phone No. (�9�=/) ��� I�3 Zip Code: -TCIPS Fax: E-Mail: Phone No. 7I > S Fill in fee simple Title Holder on next page(if different E-Mail: iir/ A co, zm from the Owner listed above) State or County License: S"�� If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.;; it SU-PPLEIVIENT.AL CONSTRUCtION LIEN LAW INFORMATION �. . DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY:.I tcable Name. Name: Address: Address: City: State: State: Zip: Phone Zip, Phone: FEE SIMPLE TITLE HOLDER: _Not Appl' a BONDING COMPANY: ___—Nb 'Applicable_• Name: Name: !I Address: Address: City: City: Zip: one: Zip: Phone: OWNER/C05NTRACTOR 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 covenantsjthat may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any rest fictions 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 Amendm nts. 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 lenderor an attorney before commencing work or recording our Notice of Commencement Signa re of Owner/Lessee/Contractor as Agent for Owner Signatu of Contractor/License Holder STATE OF FLORIDA ' STATE OF FLORIDA �I t COUNTY OF a �� COUNTY OF The r oing instr ent s acknowledggg fore me The f r oing instr nt as acknowledge efore me this day of 201_ y this day of ,I 20y �1 t- iZJ001 erson ma 'ng statement rson m king statement ersonaflv Knox OR Produced Identification er onally Known OR Produced Identification T e of Identification Produced Produced ' A L N1 •" N•� �* P IIC (Signa t�i�r34= �IPdd� (Signature of :- - � 'df'FIbiS1��34730 =N u z= or omm.Expires May 27,2019 - o: G . SOF F� �� , My Comm.Expires May 27 201.,n ��" Bondedthrou h Nation Commisslofn �{�°`' Rnninifhm nhtb' ne a 9 ssn.� tional tvot�( � Commission 0. I REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED I, Rev.8/2/17 I ii