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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 7- a2 Permit Number: ma, -- SM, DUIIQing rermn Hpplicavon planning and Development Services Building and Code Regulation Derision 2300 Virginia Avenue, Fort Pierce F! 34982 Commercial _ Residential Phone: (772) 462-1553 Fax: (772) 462-1578 PEKM1 I APPLICA I IUN FOR: To Select from dropbox, click arrow at the end of line pRopOSELU I_NAPKU_V_EMEN I LOCAI ION: _ Address: 7 80 5 Legal Description: ©602©(� J Lot No.___ Property Tax ID #: Block No, Site Plan Name: Project Name: Back: _ __Right Side: Left Side: Setbacks Front DE I AILED UE5CKJP- I K3N t3!- WOKK: z�r LI�tC-.�/ VS, -,-,r C��`�s` oar l�/�� CONSTRUCTION INFORMATION: on wor o e er rme un er is permit — c ec a app � Gas Piping Shutters I�IHVAC Gas Tank EI ectri c Plumbing LJSprinklers Generator Total Sq. Ft of Construction: r Sq. Ft. of First Floor- utilities: loor: _ uti€ities:OSewer 0Septic Cost of Construction: $ OWNER/LESSEE: Narr+e Rok"t '7 L 5°4J Z Address: State: i7lr City: n7 c� ura c zip Code: 34 q SL- Fax: Phone No. '336.45►8 E -Mail: FN in fee simple Title Holder on next page { if different from the owner listed above) CONTRACTOR: FWindows/Doors 0 Roof Roof pitch Building Height: Name: C (' 1�C Z l SFS (Ll 4'\0 (1 5i — nS'", All, .r S S�eVbl� Company: Ikl5 �1 11 da r�ei1 / Address St . Luc( State: i C_ Pop--r9t, City: Zip Code: 3 4-q 5�-- - Fax 771 j.3 ,5- t a Phone No. E -Mail: tCcrl l - C G' 5 [ 1 State or County License: if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEM EN I AL C:UNS I RUL i ION LIEN LAW I NLURMA I ION: DESIGNER/ENGINEER: Name: Address: City: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: _ Not Applicab State: Not Applicable MORTGAGE COMPANY: Name: Address: r` it-\ Zip: Phone: BONDING COMPANY: Name: Address: City'. T1 p: Phone: Not Applicable State: Not Applicable I certify that no work or installation 'slots commenced prior to the issuance of a permit. St. Lucie County-mak?s no representation that is granting a permit till authorize the permit holder to build the subject structure which is in conflict Lysin any applicable Home Owners Association rules, b,:lav,s or ana covenants that may restrictmay orprohibitsuch structure. Please consult with your Home Owners Association and revie_a! your deed for any restrictions vahich may a I In consideration cf the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance rrith the approved pians, the Florida Building Codes and St. Lucie County Amendments. The follovling building permit applications are exen,.pt from undergoing a full concurrency review: room additions, accessory structures, {wimming pools, fences, .•�a`Is, signs, screen rooms and accessoR, 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 L to obtain financing, consult with lender or an attorney before before the first inspection. If you in commencing work or recording your Notice of Commencement. - Signature of Osv-ner/_essee-Cantractor as Agent for O:vner I Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OP— The The forgoing instrument .vas acknowledged before me this / day of J v / 10 41 , (Name of person acknowledging j ,{ /LL, (Signature/ellloflll Notary Public- State of Fier a j Personally Known OR Produced Identification Type of Identification Produced_ — STATE OF FLORIDA COUNTY OF 't�Z 4 The forgoing instrument was acknowledged before n.e this /oZ day of V L)/ 20 ! by t! j eq (Name of person acknowledging ) (Signature of Notary Public- Stat of ; lor'�' Personally Krim4m OR Produced Identification Type of Identification Produced yp Commission No. (ri G7c�EONFI(imission No. ii L--1 t it J �t * * 2021 Dt�iR_EnS��Aprv.�-...v Ny�op?%-0�c 80:1ded Tlvu .+"...J21,`.t2 sm— i Revised 07/1-:V2014 REVIEWS FRONT ZONING COUNTER REVIEW DATE COMPLETE INITIALS SUPERVISOR PLANS REVIEW i REVIEW * MY COMMISSION JIGG 052548 EXPIRES: A014, 2021 VEGETATION i SEA TURTLE I MANGROVE REVIEW REVIEW ` REVIEW V15