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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: _ 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. l O 10W Address: J044 L-goPf L 01� K 4h Legal Description: Property Tax ID #: Lot No. Site Pian Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED- DESCR"IPTION Ok WQRK." KF_mme,1 Krmi46N t;�i� "rS 7'0 MEW 917igCAJ LA dpi f CAA)s JAJ ��1�✓�,�i Fpi�jT SF.b-- AN> It CAMS rv)AS-)Vk - ADb q C,,N_s nuumonai worKco oe errormea unaertnis permit —ci HVAC LJ Gas Tank ®Gas Piping Electric ❑ Plumbing Sprinklers 'total Sq. Ft of Construction: Cost of Construction: $ /OX L_1 Shutters FGenerator S . Ft. of First Floor: _ Utilities: Sewer —Septic ][Windows/Doors Lil Roof Roof pitch Building Height: OWNER /LESSEE: - CONTRACTOR: Name _75oH t) d`' QALi AN Name: APUPOP, 'r-M66L M40,1 Address: Rog Fo>C Po,A; :l,L Company: A ewpz ine oizicftl Coni- ,kBeTeNb, t,Jc_ City: f� Lr,) 'CrFq State: rL. Zip Code: _ Mq O Fax: Phone No. 3Z 1—dc-a— )31 Address: °7/ T3 GON071 071 P� City: P09__r S'r I,vcle State FL. Zip Code: .347S -a Fax - Phone No. 77,�- 370--57S..5 E -Mail: Fill in fee simple Title Holder on next page ( if different from the owner listed above) E -Mail: Acro,"—Te ELF -r- kic PSL Q-00-1-309, CON State or County License: CC00030 ?a It value of construction is $2500 or more, a RECORDED Notice of Commencement is required. . PI%Jf.r_FVG1V%31MttK: Not Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip' . Phone: OWNER/ CONTRACTOR AFFIDVIT. Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that noo work or installation has commenced prior to the issuance of a permit. wh ct is inoco tlicmt with any applicable iHomeaOwgranting ssoe permit rules, bylaws or andpcovenantholder that may restrict subject structure t such structure. Please consult with your Horne 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 improvementsV your property. A Notice of Commencement must be recorded and posted on the jobsite before the first; spection. If you intend to obtain financing, consult with lender or an attorney before commencin'Work or re 4ing your Notice of Commencement. /} Signature of as Agent for Owner I Sign re of STATE OF FLORIDA COUNTY OF The forgoing instru nt was act wledged before me this _ day of .pL—by Name of pers �n ma" g _statemen# M Personally Known — � ��lyr-io luced Identification Type of Identification Produced (Signature of Notary Public --State oy `r+f/ Commission No. .0OG•r/1 *: REVIEWS FRONT - - COUNTER ,ticu COMPLETED Rev. 8,/2/17 Holder STATE OF FLORIDA COUNTY Oi Ne The forgoing instru nt w ackn ledged before me th isef day of 20 i�by Name of person ing statement Persona Iiy Known �©R Produced Identification Type of Identification Produced {signature of Notary Public- ate of F ••.. G` af• Commission No. * •:}��� 0 : o iM�G 137ip7 PLANS I VEGETATION I SEA REVIEW REVIEW RE k 0 �k U) In � Eom 00 CO tiV 14, tZN 10 -ID-V- ------------------- -------------- / ------------ I ------------ --------- : WRINI V) m a (D IM V) A I -0 IM Q V) 0 0 M, V, O IN cn 0 4� 0 6 4-d CL 0 x (D �i jjT clOAAG DWCP3634 10 G m Ln CL C C\j T— o LL N T— m 1 7 LLI N co 0 In DWCP3634 10 G m Ln CL C 42 —4 11 3611 ., 1 s. —f 31511 25"—f 2411 W ffJ