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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLI ^ABI E IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: .. i_ Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982m Phone: (772) 462-1553 Fax: (772) 452-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMP OVEMENT LOCATI Address: Setbacks Front Back: Right Side; _ Left Side; DETAILED DESCRIPTION OF WORK: CO S RUC I INFOR TION: ined under t is per it - c ec a a HVAC Gas Tank 0Gas Piping_ Shutters Wi ows/Doors ,Electric Plumbing Sprinklers E Generator 0 Roof Roof pitch Total Sq. Ft of Construction:: 2 Sq. Ft. of First Floor: p Cost of Construction: $ �'I J6. Utilities:Sewer 0 Septic Building Height: OWNE#�(LESS�F : V - I CONTRACTOR: �-- , n`l Addr S -1 -JR -Ow— 11 IN god'i Cit State: 2M Zip •.- • Phone • Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name:c, Compan City: Zip Code;, Phone No. E -Mail State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. Fax: State: SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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: niarnlrn 1 r%^Rlrn A .-... .. V"IYGR/ a.vly i nM% -i urc Rrrluvl I: 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 recoding your Notice of Commencement. Sigpdture of Owner/ Lessee/Contractor as Agent for Owner Si ture of Contractor License Holder STATE OF FLORIDA STATE OF FLORIDA ' COUNTYOF COUNTY OF7 The foo ing inst u n a ledge efore me this day of 20, by Name of perso,n.�+aking state e t Personally Known i OR Produce dentification Type of Identification Produced (Signature of Commission No. REVIEWS DATE RECEIVED DATE COMPLETED Rev. 8/2/17 The f& otUM�;OZK ing in edge efore me thisday o by Name of person king statement Personally Known � OR Produced 1dE Type of Identification Produced (Signature of Notary Public -State of Florida } ATHENA Ir STE9N13ERG wLCQMM166�86 Commission No. EXPIRES April 13. 2019 fANMRNN. o,y Se rvtce.cotr FRONT ZONING SUPERVISORPLANS VEGETATION COUNTER REVIEW REVIEW REVIEW REVIEW ATHENA 9 EXPIRES April 13.2019 SEA TURTLE MANGROVE REVIEW REVIEW