Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED - Date: ill 17. 1 -7 Permit Number: I V LEE E Building Permit Application OCT 17 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: P � QxP©SED INPROVEIUIEN LOCATIQN: Address: 5 P 1-172 R hA V P AV Legal Description: -iy9 P—.y Q i' �S C L)N -1 ( �­7 Lill Property Tax ID#: 510 2 G-0 D�A `0 Lot No.Z Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETALLED DESCRIPTION WWI C®I lSTRUtT®N I INFOR+NATION: Additional work to be pertormed under this.permit-check all that appy: _Mechanical ` _Gas'Tank Gas Piping _Shutters _Windows Doors Electric _Plumbing _Sprinklers _Generator Roof 1Z Pitch Total Sq. Ft of Construction:.: 2-il0Sq. Ft. of First,Floor: j Cost of Construction:$ L2-11 0O Utilities: —Sewer _Septic Building Height: DC7 MNERILE-.S�SEE: C©NTR CTR: Name .0� t�c7 Name: l V i'l� QA-�t L 7 Address: 9.0, Lil Company: City: _FV State: Address: 1 Zip Code: © �S� Fax: 0 Pic City: O V'- L-Ljll State: Phone No. 52 Zip Code: S(+Ci S2- Fax: E-Mail: dfi Phone No r'r L1 15 T Z Fill in fee simple Title Holder on next page(if different E-Mail C t i.) from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Sl1PPLEMENTAL C®NSTIRtl1,�Tl®N LIEN LAW WO 107, 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 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 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. IOU- Signature of Owner7 Lessee/Contractor as Agent for "frk i,'*; '` Signature of Contra ctor/Licenseo er """ 0 ra n Z n STATE OF FLORID a X�r STATE OF FLORIDA z COUNTY OF o COUNTY OF m { The forgoing instru nt was acknowledged before m Z The for ing instrume wa acknowledged before this day of 20�by `=T this day of 20J7 by �T 9 ta (Name of person acknowledging) (Name of person acknowledging) (Signature oftary Publi State o Florida ) (Signature o otary Public-State of Flor da) Personally Known 7OR Produced Identification Personally Know OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED eV. 4