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HomeMy WebLinkAboutBuildimg 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 Address: `C- Legal Description: = Wcie- Property Tax ID#: "7©3'i Site Plan Name: Project Name: I S Setbacks Front Back: 11 Electric Commercial Residential-� Right Side - hal AC ElPlumbing Total Sq. Ft of Construction: Cost of Construction: $ 52-0© Name',hAt b I NAMA v , Address: ;�'%A []Sprinklers Left Side: L _I Shutters Generator Sj of First Floor: _ Utilities: L�J Sewer 11 Septic City: _��I� 1C t,1 11 G L State: Zip Code: S2 Fax:-772 3q�z'? Phone No. '?7Z E-Mail. Fill in fed imple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Lot No.—7o_ Block No. QWindows/Doors Roof Building Height: Roof pitch Name: j Company: 1 Address: IS2y cSL 6% V- ; City:/�1 1t (�(C I State: Zip Code:, �F7ax:1ZL-36 g0— 7Z-% Phone No. _:::�.7Z3% 9 12--9- E-Mail: State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 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: uvvnICK/ WN I KALIUK AFFIUVII: Application is hereby made to obtain a permit 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/work or recording your Notice of Commencement. /„ 1 of'Ow,her/ Lessee/Contractor as Agent for Owner STA;rE'OF FLORIDA ,�( COUNTY OF ak t� The forgoing instrument vfas acknowledged before me this 1 day of QDvem Plb/ 20 1 q by Name of person m king statement Personally Known OR Produced Identification Type of Identification Produced Contractor/License Holder STATE OF FLORIDA �„ I COUNTY OF l CI C The forgoing instru ent was acknowledged before me this __L day of 0 Y4_'. 20ij- by Name of persorymaking statement Personally Known V OR Produced Identification Type of Identification Produced CRAIG A. GROSSMAN MY COMMISSION 0 FF990902 (Signature of Notary Public- State �� 56 F.lo d otaryServiceggnatu e of Notary Public- State Commission No. (Seal) Commission No. CRAIG A. GR1 MY COMMISSION (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/1 i