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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST..BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 hone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: IIN!PR-@AEM;E,T LOCATi�i.(g+4 AJldress: 9 50 S � �1�- 11 Legal Description: Property Tax ID#: L2, od o2 Q 6o Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Dfl'AI�LED DE=��CRIPTION QF WORK• 6 ' Woar I C®NSTRUINTI'1113 IN`I.iffi ION: Additional work to be performed under this permit-check all that appy: _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:$ ��Qo Utilities: —Sewer _Septic Building Height: OWSi' R lIUS ff C(+7NT iA TOR: Name 6 N O L-G c Name: Address:2YOO; - Oc'eA DJ C ��Z Company �f�,�ver,� o•��" City: h'P,L_ State: L Address: ��� i�Menl A '/ / 7 _ Zip Code: 3��y -1 Fax: City: °1-eec z- State:_L Phone No.`7`7 2- 6-7?- /-r ,FO I I Zip Code: 5'9!/ 5 Fax: !E-Mail:' /elf�k S ��L)to�7) F/Z2�4�MA�l Phone No '7')cP -,:PIC 2F Fill in fee simple Title Holder on next page(if different'Am E-Mail oc9�,Pr ti i�� ` lk-d_ from the Owner listed above) State or ounty License `Sl If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUR%W1@@1 8NOt L CONSTRUCTI©N LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable 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 comme work orj;ecording your Notice of Commencement. Sig ure n essee/Contractor as Agent for Owner Sign u o C ct /License Holder STA F STA COUNTY OF IDA p N•t�C�e.. COUNTY VIM 'C= 'License forgoing instrument was acknowledge before me The forgoing instru e t was acknowledged before me this 3 day of M 20 by this 3 day of 201J_ by V) (Name of person acknowledging (Name of persorT acknowledging) (Signla'turb of Notary Public-State of Florida 14,Anakre of Notary Public-SlAte of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced ���Ry� ��, LASHI�HNA NGRAM � � , LASHAHNA If�B Commission No. ,o�P �a , Se { Commission No..�`cPr-Sao tary Pub is- ate of Florida iuotary Public-State of Florida E. Z. ; 1 = My Comm.Expires Dec 20,?010 kJ-,�a f> 1 = My Comm. E;.pires Dec 20, 90is FF ,7i 2•. d REVIEWS FRONT..; ZONING .� 'SUPERVISOR PLANS VcfG.ETATION '-:SEATURTLE" MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014