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HomeMy WebLinkAboutBuilding Permit Application � 4 AII,APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 2 tMM Building Permit Application Planning and Development Services Building and Code Regulation Division 2.300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial. Residential PERMIT APPLICATION FOR: PROPOSEp,INPROVEMf NT LOCATION. Address: Legal Description: H r`7L ey Lo-fly - �u� �fT -� A,A, °rte Property Tax ID#: 3 t Orr).-- 3)6o -00 " 7 Lot No. 2 Site Plan Name: Block No. Project Name: Setbacks tbacks Front Back: Right Side: Left Side: .e : r DETAILED DESCRIPTION C?F WORK R41- 36 . S MV /6 SJE CONSTRIiCTtONINFORMATION Additional work to Be performed under t is perki'7'C eCat at appy: 14Mechanical _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: $ n?Rdd `fir Utilities: _Sewer _Septic Building Height: tJV1UER/LESSEE _ CONTRACTOR �- __. �. Name D Name: zer--A H e Zi(, t"- Address: S Company:7�;.. S � City: 62-6t,12L-1 State:State: Adi ress:�S.C4i) Rc/a-,?j w a,._ /1l' ;Zip Code: .`�y!2ra Fax: City: ao i`± �,`c.�. State: tl— Phone No:.,� _3:0- 7 7 �/ Zip Code:..` y� Fax: E-Mail: .­ Phone No 7 �Q= -3 20 — / 7,7 6 Fill in fee simple Title Holder on,next page(if different E-Mail--,e •( LJ4 from the Owner listed above) State or County License Cd C- 9 195gl 0 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEIVIEfV1`AL CONSTRUCTION I"IEN LAW tNFC?FtMATIC}N. .,: p DESIGNER/ENGINEER`� - � >� � � _Not Applicable T 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 commenci,Rg work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Sign re of ontractor/License Holder STATE OF FLORI STATE OF FLORIDA COUNTY OF 4LL_ _� COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledgN before me this-Il day of 20by thistt�day of 1 20 by an In is 1(' A � W�� (Name of person acknowledging) (Name of person acknowledging) (Si ture of Notary Public-St of Florida) ' nature of Notary Public tate of Florida) Personally Know OR Produced Identification Personally Know OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (gA�pha�� Commission No. LASir IN(iRAM _� LASHAHNA Notary public-State o1 flo2p18 o��av'�a�;.,; Notary public State of Florida 20. 2018 • . My com ,, F 177249 :_° *, y comm.rXV, -- 7 49 ' ° ssion F i FF 72 REVIEWS F ©,q o��ZO�1fNC,' S.IIRII PLANS VE SE`Ar'T c ol�Eanal oM OVE gn ri.ti. CO lel ;;,'' Rs. r u REVIEW Rg0nE DATE- RECEIVED DATE COMPLETED Rev.