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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO-MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p�7 Date: � �' 17. Permit Number: / / 1 0-0 231 U . iia :::. .. r Building Permit Application OCT 1 i 2017 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: PRO &SED1 110iRQUEMENT L©CATI'®N: Address: )16FA , _3L4CI S, Legal Description: Property Tax ID#: 13 0 ^l C 0 0 t) L-) n (00 �. Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D�1'AILED D ASCRIPTION OF W©R d' (,� ,� d I) T7 `T 1= f�U r- r curl C= 1-�ar,( ho C PCAI r E-:e,-A_1 fir- hoid t 6l �wkFi 6X3'PT I���G s ��oW3Dx �cL Zj(C4 .&t K �1KL1 .�tT�Z G CC3NSTR+UCT[�N 1'N'FQR+MATI©N: Additionalwork to be performed under t is permit-c ec, a t at app y: Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers . _Generator _Roof Pitch �p S\6 3�tY gR 1 c Total S 1`t of Construction:���_�6_q �-Sq. Ft.of First Floor: - Cost of Construction: $ �, ©n Utilities: _Sewer _Septic Building Height: OWNER/LESSEE, Name Vet C ,600rak, 'a Y-4�S Name: Address: 770Y 32,dmc-s Company: City: ,P;P rr V Fl• State: Fj- Address: Zip Code: Fax: City: State: Phone No. 772_ .2-5z-y`{?S Zip Code: Fax: E-Mail: 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. I i 921PPLEI�tIEN�E"A�C®N'Sl"REJ�TI®N LI=EN L,�1W I�NFO�RIUlA1'!O'N: 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 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. ignature of Owner/Lessee/Contractor as Agent for wiser"` # Signature of Contractor/License Holder m r. STATE OF FLORID v� STATE OF FLORIDA COUNTY OF i z EZ- COUNTY OF Ko= The forgoing instrume was acknowledgAbefore ° z' The forgoing instrument was acknowledged before me this I 1 day of20l(.by mT.= this day of 20_ by (5,Q . V`/ i • N Name of person making statement. Name of person making statement. Personally wn OR Produced Identification Personally Known OR Produced Identification Type of Identification, Type of Identification Produced Produced (Signature of No Pu ic-State of Flori ) (Signature of Notary Public-State of Florida) XIJA Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17