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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: =0 Ali Building Permit Application Planning and Development Services ,wilding and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-3575 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, dick arrow at the and of line PRf]POSE#? IMPROVEMENT LOCATION Address: x50. w Legal Description: LADQ rt U n - I L L.,3 45 l) and 1.-1 6,0 l abi A I-io I - 9bU Property Tax ID #: O i — (-Oc? Lot No. Site Plan Name: Black No. Project Name: Setbacks Front Back: Eight Side: Left Side: DETAILED DESCRIPTION O� 0RK. ou� (A,-P -)c L4�e, e kc rn o� ©r), ) U �5 EG2, � i cDV,�) i 6 c,14 c)-l i RC 30 b )(a� I CON-STRUr-TION.INFORM-ATION.-.- Additional work to be nertormea un er this permit —c5e-ck all apply-, x EKVAC Gas Tank EJGas Piping Windows/Doors _Shutters LTJ Electric ❑ Plumbing Sprinklers FIGenerator Roof Roof pitch Total Sq. Ft of Construction: S. Ft. of First Floor: Cost of Construction: $ UtilitiestSewer ElS.eptic Building Height: O��rN�R/l~�ss� - CON��AcraR NamecSGn p�}r __ ^ Name: Address: D Company: r 0-L City: r a...--.- State. Address: ©� Jc , � &-e— Zip Code: �,q q M Fax: ^ City:—1-YO&t --- Stater Phone No. t- zip Code: 3L/�?tL Fax: E-Mail: Phone No. Fill in fee simple Title Holder on next page { if different E-Mail:,y, from the Owner listed above) State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL. CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: city: City: Zip: Phone: Zip: Phone: nWNFl7/ rnRJTQer-rr%D neeir% i r. . - -- — .. •-- • —— I I . nNNncarron is hereby mage 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 your Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORID COUNTY OF The forgoing instru ent was a knowledged before me this 1p - day of 20Z by r Name of person making statement Personally Known _X OR Produced Identification Type of Identification Produced 1-1). CM k (Signature of Notary Public- State of Florida j Commission DONNA M, HILL09 Seal .; # GG 038 r Q: EXPIRES: April 30, 2021 Bonded 7hru Noteiy Public Underwriters REVIEWS FRONT ZONING SUPERVISOR COUNTER REVIEW REVIEW DT RECEIVED DATE COMPLETED Rev. 8/2/17 56z_-� 7 Signature of Contractor/License Holder STATE OF FLORIDA COUNTY 0FL c The forgoing instr ment was acknowledged before me this _6 day of 200& by Name of person making statement Personally Known. C OR Produced Identification Type of Identification Produced n,'� " q,�t (Signature of Notary Public- State of Florida DONNAM. HILL (Seal) 4M ION # GG 099038 EXPIRES: April 30, 2021 REV EW T ARE I WON S EV EWLE I M EVI WVE