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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ Date: Permit Number: � �� I [BAR 19 2013 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 i-; PERMIT APPLICATION FOR: PROP Address: ? ��'r�//� Li4 C,IL'C (_E Legal Description: Property Tax ID#: �" © Lot No. Site Plan Name: Block No. Project Name: / 4("c cj T� ✓f N !� C LLP Setbacks Front Back: Right Side: Left Side: VC 'WOR`: / //��/�C�✓L- LAK� /7c��L�/�� ,S%•�-G �,s�dVi) .�(���-1� �r.�/ Additional work to be pe Orme under this permit–check all that appy: _L/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: $ ����� Utilities: _Sewer _Septic Building Height: N:T AA. OR:.,. Name 1;_ 7—L Name:��oc' i,•� G �.�L,s ,�iL Address: 37.Zo lel' u LSA LA Company: ltj ij.Lf}77�x�.��G. City: % �- Stater Address: �3G �¢9G� s,tJ�sTu/1u Zip Code: ?SSz Fax: City: _ i C ��i�� State:125� Phone No. 6�o – Jo�1-62�27 Zip Code: ���_sz Fax: E-Mail: Phone No ?'7 2 s,373 G Fill in fee simple Title Holder on next page (if different E-Mail �,'r-Lit ('��U_ S' u-7_9 from the Owner listed above) State or County License A If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 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. ;;�:+,• -•fir, f / g9r_ V b: •:T�� ,,1d,�•w'o�' Signature of Owner/Lessee ontractor a Agent f Signature o Con ractor/License Holdor o STATE OF FLORIDAg M< STATE OF FLORIDA 2 ME Q COUNTY OF z:2o COUNTY OF Fu The forgoing instrument was acknowledged efor Jig= The for oing instrument was acknowledged bef4M this day of �>9 IAC ,20by 4- this day of n7*R_0, bL 20 by j 8A �- TS N A 2m7 bz N JDa N 14 Lt LL-) ,S �N �-i), L.c._I (Name of person acknowledging) (Name of person acknowledging) 6"xt4a n QL _J A a" (Signature of Not 0 Public-State of Florida ) (Signature of No Public-State of Florida) v V Personally Known OR Produced Identification Personally Know OR Produced Identification / Type of IdentificType of Identification Produced do ' -k L 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.7/2014