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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: - � Building Per it 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: PPCSED�xINP .VEII��ENT L: CAITI # .e 'VOW RcYffi�11$ " Address:. o Legal Description:. P ioperty Tax ID#: 3gQ'3 S"° Lot No. Site Plan Name: Block No. l - Project Name: Setbacks Front Back: Right Side: Left Side: 11 W- 14 11-111M� oscR�PT�o��p„NcF 1IUCIRK�.G a , W_ ve O 0 ©1A C=o .r o C �. e e ;d c e- � " FP v I o d N' lit` eq a� z x Additional work to be pertormed under this permit–check all that apply: Mechanical _Gas Tank _Gas Piping . Shutters _Windows/Doors _ 1Electric _Plumbing _Sprinklers Generator _Roof . Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ D tld, ° Utilities: —Sewer _Septic Building Height: Name Gct(,�,ape g u Name: j4qg&& ,r; "M 61011 A 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. Tff X 4. Sign aturev er/L see%Contractor as Agent for Owner Signature?f nt actor/Lr se Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The or oing instrent was acknowledged before me The forgoing inst ument was acknowledged before me m this l day of 201 by this-UL day of 20 by (Name c" n cknowledging) (Name of person ck le ging) (Sikpzfurel of Notary Public-StMR of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification .Type of Identification Produced ;,—"�1 ' y - } .1NF INGRAPJt Produced �� `'°��a�rye`'' LRS �', A Notary Puoiic State. Ftorria 14 b My Comm.Expires Dec 20,201iiz, Notary Public State at Flo Id? �; oc Comer FF 1772}9 Commission No. =_ al: rnm.Expires Dec 20, ',pr O"_' N° _ *. �, Commission No. ''.,9 P•. ) Commission #FF 1772r 9 �.,, ,,.� Bonded roug �LtionalNotaryAssn. I FOFF���`` Bonded through National Notary Assn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE -MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.