Loading...
HomeMy WebLinkAboutBuilding Permit Application I ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEI Date: PermitNumber: ® RECEIVED Building Permit Application I FEB 112019 Planning and Development Services j Building and Code Regulation Division . Sr. Lucie County, Permitting 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 a�the end of line PROPOSED IiVIPROVEMENT LOCATION . _, �; .: - Address: 1z f C✓r- AleG Legal Description: C. Property Tax ID#: _(��m/Q• %/�' �'0I'86�'(� Lot No. Site Plan Name: ' Block No. Project Name: Setbacks Front Back: Right Side:; Left Side: DETAILED DESCRIPTION OF WORK CONSTRUCTION INFOR1ylAT10N Additional work toe e rme un ert is permit c ec a appy. 0HVAC 13 Gas Tank []Gas Piping _Shutters Q Windows/Doors DElectric Plumbing 0Sprinklers Generator Roof Total Sq.Ft of Construction: f'-_6P" S .Ft.of First Floor: Cost of Construction:$ D d d T Utilities: Sewer Sep 'c Building Height: OWNER/LESSEE CONTRACTOR 1 _. w Name Name: s-Fi - 7 P7 - C Address: cod Company: K c e City: ti-e G' tater Address: L C ;' c1-P_ ire /a JEcl Zip Code•3 Y y Fax:— city: fVlC61C _State: Phone No. Zip Code: • Fax: 7 a- 66 E-Mail• Phone No. 7�7 3 6 Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or Coun 'cen e: ff value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i DESIGN ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: Qty: Stater City: I State: Trp: Phone: ZIP: Phbne: FEE SIMPLE TITLE HOLDER:- '-_ Not Applicable BONDING©DMPMt . Not Applicable Name: Name: Address: Address I ' - - QtY• - , Zip: Phone: Trp: Phone: I caroti►that no work or Installation hascornmencedpriwtotheissuanceof a per nit St Lucie Cour maioes no repress etion that is granting a it wilii a Drize the it older to build the subject structure whidr is in oo with an appli Home Owners A n rules, "and Yy�- d rrts that may restrict or prohibit such structum Please consult vrtUtyour Home Owners Association and review your deed for env Ontrictions which may apphl. In consideration of the granting of this requested Pernik I do hereby.agree that 1 wHL in all i 3spects pmrorm the work In accordwroe with the approved plans,the Florida Sidk rg Codes and SL Jude County Am Thefdbwingtiriilding Permit app!&atlore are exernptfrom undergoft a fun conwmencyFanothernowreddlentleluse m addition accessory strucdue�,swimming pools,fences,wails,siigr�s,ween room�,and accessoryus WARNINGTO OWNER:Yowfailuret4 Record a Notice aF Commencement stayyotir,oayirG twice for improvements to your prgperty.-A Notice of Commencement must be recorded and posted on fife jobsite before the first inspection.If you intend to obtain finandrlg,consult with tender or an attorney before commendna work or recordinit vour Notice of Commenoeritent Signature of Owner/App Lessee Slgnature of Holder- STATE OF FLORIDA STATE OF FLORIDA CDtMff OF COUNTY OF The forgoing imM am as aclo o edged before me The iru�rtr A! as�beforeme 1.J_dir - _2 by this•(, dayof 2o�Qlby (Name ofPerson admowJedging j (Name of personadmawledgirrg) (Signature of Notary Public-State of Florida) (Signature of Notary -State of Florida) PersonallyKnown OR Produced identification Known �' I OR Identification Typeof IdenMation produced T of identification �� Commesion No. (Seal) Commission Na (Seal) KAREN S. N1-&L-SEN - ,+������,cut Flu,id - - '� ��1 YAU�G K _• *� n7 tate Of Commission k GG 207484 _'. ,_ Florida-Notar Revised 0711 ='r Pic My Commission Expires ;f POPS; Commission #GG 2074840 .lune 12,20 2 ���' °LO+`�� (1�y COn'1missio ,.a n Expires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIO SEATURTLE j�"VE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS