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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAPLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: MEW Building Permit 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: �S r p ,_ )4q — Legal Description: h�`'��� C ' Cb-op PropertyTax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: _f6fad mu) 1W 146E�P,, Ju;, rON.., q � W 11 i G o CONST UCTION INFORMATION: Additiphal work toe nertormed under this permit—check all that apply: HVAC 0GasTank F]Gas Piping _Shutters Q Windows/Doors 11 Electric 0 Plumbing Sprinklers a Generator Roof Total Sq.Ft of Construction: SFt.of First Floor: Cost of Construction:$ ��© Utilities:�Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name --uX1n(tA Name: O Address: '?7 , ,i.e, ,.]l1�',�,. ��5� Company: � City: ..- L , State: Address: Zip Code: Fax: City: Rea State:A_ .t Phone No.17,2 -3;�1-0412 Zip Code: 15i Fax: -77d---q&&-37.37 E-Mail:0A Phone No-122- 4D1_414_1 Fill In fee simple Title Holder on next page(if different E-Mail: 110r'h from the Owner listed above) State or County License:/ Gtf$t�lti If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNERANGINEER: !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: I certify that no work or installation has commenced prior to the issuance of a permit. St.Lude 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 Assouation rules,bylaws or and covenants that may restrict or prohibit such th structure.Please consult v 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 tender or an attorney before commencing work or recording our Notice of Commencement. T Lu Signature of Own Agent/ ssee Signature of Contractor/LicenAol STATE OF FLORIDA � � ( I,�I� STATE 1�0 �LORiDAt- COUNTY OF COUNTY 1-�b The f,Q�oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 's'"day of a 20�by�, this At day ofC'( 20 by[,r� (Name of person acknowledgin ) (Name of person acknowledging 646�- �. 6xa�?- -V 'Q. &—Xzaa� (Signature of No Public-State of Florida) (Signature of Notary bli State of Florida) Personally Known M2 Produce tent E Personally Know Type of Identificati P` ti late o Type of Identifica n GG 017839 =°? Notary Public•Stale of Florida Commission No. `�` '•+, : ,14{t ll�es Aug 2L 2020 Commission No. !. Commiss4fi6 �017839 °`'• 15'. ,led tniuugr National NotaryAste. My Comm.Expires Aug 21,2020 nes` Bonded thropoti National Notairy Assn Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS