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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: q05-C)qq �© Permit Number: I r - 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 F`ROPOSED IMPROVEMENT LOCATION Address: lr*!L Legal Description:. r4ctil S l — S�r^cl� . L6 - Lp Property Tax ID#:— 6� (Q f��� 000, Lot No.� Site Plan Name: . Block No. Project Name: Setbacks Front Back: Right Side:. Left Side: DETAILED DESCRIPTION OF WORK L.— .4 S r�r3e�i�s ® SL 491V CONSTRUCTION INFORMATION itio work to be e orme underthisermit—check = • p a appy. _ ❑HVAC Gas Tank . Gas Piping _P g Shutters Q Windows/Doors ❑Electric ❑Plumbing []Sprinklers ❑Generator ❑Roof Roof pitch Total Sq. Ft of,Construction: S . Ft.of First Floor: - Cost of`Copstruction:$Q(��_ Utilities: _Sewer❑Septic Building Height: - OWNER/rLESSEE CONTRACTOR L Name Name Ad s CQ[npany Y:" CV State: b—�— Addres ;_V 9�pJ�- Z"ip Code: Fax: City: j�T� 'S`F Lac State: Phone No. '9a.d —so c Zip Code:349 5�3 Fax: 672q_f$623SL— E-Mail: Phone No.22,;�- Fill in fee simple Title Holder on next page(if different E-Mail: (9 from the Owner listed above) State or Coun4 License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUFPLEMENTAL CONSTR'UCTCON LIEN LAW INFORMATION: DESIGNER/ENGINEER: _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.Lucie County makes no representation that is granting a permit will authorize thepermit 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 our Notice of Commencement. kl/ s Signat a of Owner/Lessee/Contraozras Agent for Owner Sign6ture of Contractor/License Ho r STATE OF FLORIDA STATE OF FLORIDA COUNTY OF L-oa& COUNTY OF S+- Luc-i Ls The forgoing instrume t was cknowledged before me The forgoing instrut was a knowledged before me this� me day of 20 aby this G/9 day of 20 by AA6VI E f (Name of person acknowledging) (Name of person acknowle ging) (Signature of.Notary Public-State of Flo ' a) (Signature of Notary Public-State of lorida) ` Personally,Kn6rn :-� OR Produced Identification Personally Known OR Produced Identification Type of-Identification Prodduced Type of Identification Produced - Commission No.�: 113� S 'J � (SeECAROLIIWEAGIf Commission No 19S3314, ��� (Sef1'�A�GE Commlii;"#GG 195331 . * Commission f GG 155331 • • d,, a ExpkuApd 5,2022 BaiMditru6�dNtM�Gq'Surbe� ocr�� ��dplNoluys�rfco Revised 07/15/2014 REVIEWS FRONT ZONING' SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS