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HomeMy WebLinkAboutbuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State- Zip: Phone: City. State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: Address: City: City Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. no the permit holder to build the subject structure r and covenants that may restrict or prohibit such ped 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 resuk 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 91 STATE OFFLORIbX�c' j,�,� COUNTY OF J +�1� The forgoing in ment was acknowledged before me thisrpu'^dayof Si 201-rbyr tk ckW r- Wb (Name of person acimowledgi g ) (Signature of Notarublic State of Florida ) Personally Known Y OR Produced Identification _ Type of Iden "� w Notary Public s�]]��44 of Florida Commission ?� missio(14201)839� My Comm. Expires Aug 21, 202f Revised Signature of Contractor/License Halder STATE OF FLORIDA COUNTY OF___ % wab The forgoing instr eni fttwas acknowledged before me this �^ day of tMX()_ _, ZQ_]A by C,. r` (Name of person acknowledgilrig ) (Signature of Notary blic- State of Florida ) Personally Known Y OR Produced identification Type of Ideiktfll`d!}rP Notary Public - Star rida --Dommissbn x 21 9 My Comm. Expires Aug 21, 2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS ALL APPLICAB INFO pMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: (O Permit Number: Building Permit Application Planning and Development Services Building and Cade Regulation Division / 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V/J PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: -ph & i - i01 _�3 Property Tax lD #: l _ ©o' d%©� Oli©- Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETA&ED DESCRIPTION OF WORK_ �II A of [ ilc� - ievlvioX ,5 +bn -Ek i�j - s KW heat STR CTION'INFORMATION: oI work toe oe orme un er t is permit— check all appy. HVAC Gas Tank []Gas Piping _ Shutters J E]Windows/Doors Electric 1:1 Plumbing Sprinklers 1:1 Generator O Roof Total Sq. Ft of Construction: 4400, Cost of Construction: $ 00 Sqi —F—t.� of First Floor: _ Utilities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Mark- 4 o f �`6ilan Name: (Chaej . �0 t Address: "big/ �p�'in �i`Y1t�S � y" Company: 6' ,� city:wt YI I��/ State: � Zip Code: . � Fax: Phone No.17 Address: !. City: (()(�f�i�, Zip Coder Phone No.1-72- 4 Q( Stater Fax: 7 2 (y -%J % AI E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner fisted above) E -Mail: bo U[& a(. e, a(L,{ o o , co r),l State or County License: (�{(' I $) �' I tp n vdme or consrrucuon rs gzouo or more, a necuxunu Nonce at commencement is required.