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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q q Date: Permit Number: • ao F`AG�*Y9� 1 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: PROPgSED ROOM=LOCATI{!3N Address: 213 srX1W_) Legal Description: Property Tax ID#: Ale v,_-.5eq Lot No. Site Plan Name: Block No. Project Name: Sietbacks Front Back: Right Side: Left Side: DETAILED D.E�SC �I'PTtON OF 1NQR!K: '17Ee5 r1-7 f CO STRUC IO INFfJRMANTIM, Additional work to be performed under this permit—check all tat appy: _Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch i Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: Sewer —Septic Building Height: OW ER/LEMS CONT C'1`E•3R; 'Name �/Cwt21 Name: Address: 2Z 3 Company: City: State: Address: Zip Code: _�— Fax: City: . State: Phone No. Z G -" X37© 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. SUP CEMENT L CONSTRUCTION LIiEN LAW INPARMATIO 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. VSig—natWurelfZOwne/r/teFssZee/Coontractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing inst ument was acknowledged before me The forgoing instrument was acknowledged before me this5V day of IL I Q,, 20_a by this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signat re of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) =`' ISeaIIHNA'iNGRAM Commission No. (Seal) Commission No. Y I( ;l)is-State of Florida My Comm. Expires Dec 20,2018 c1 ';FocF.r� u nmissi n#FF 177249 W9011'hrougt Ns6f� PLANS VEGETATION SEA TURTLE MANGROVE REVIEWS FRONT, Q1 UP_ COUNTER REVIEW RE IE REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17