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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l Date: �l 1 Permit Number: M'= EFE9 E® 2Q19Building Permit ApplicationPlanning and Development Services ;Perinittin 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: PROPOSED INPR4VEMENT LOCATI't®}N: Address: d B Legal Description ✓�t � Property Tax ID#: 38 l '— (0 6 (o O a 3 3 Lot No. Ll Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: d TA LED DE�SCRIPTIQ (�3F �R All fYt1 v' C�ONSTRUCT(O INFORMATEON: Additional work to be pertormed under this permit–check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:'$ �p/,eo ©� Utilities:. —Sewer —Septic Building Height: O NEER/LE�S�SEE: CONTR GT©R: SkName.' E� /0� Uig `J5 Q5— j Name: S(i0 P'f,7> .; •2–'r5 Address::p- ;6' O' o Company: 7 �d :s ,0 Q,c lT State: Zip Code.'2 G�,S.....- Fax: City: FW Stater Phone No. Zip Code: Fax:7���?��8��3 E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail o tars•��/t/��TQC eJfrua-1 �•Cd 4k from the Owner listed above) State or County License C�6 d-36 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPL MENTAL CO S CTIQN LI .N 1A I aRMAT .,N. DESIGNER/E°NGINEER: _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: OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a`perrnit 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 wo!J or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA- /F COUNTY OF G ®� COUNTY OF ayc- The for 'ng instr nt was acknowledg before me The f ing instr nt was acknowledge before me this day of�E 20� by this day of 'r " 20 by Awl Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification _ Type of Identification Type of� Identifi a 'on Produced Produced / �-�� �0 ( ignature of Notary Public- ( ignature of Notary Public- ;,iivi' " BELINDADbR6EtY iv'r'% BELINDADARDEN i� � '': to Publir'�Mate of florida N lic—Slate of Florida 4 t Commission No. �• `-( °� Commission No. = .;_ ` . ffiR� .•: sgion#GG 169025 . ion it GG 169025 ` Boyndcd lhroo H N�Gnnros Dec Nod B As n1 `+a�: � :'My Comm.Ex}''rs Dec 18,2021 Bo REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17