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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 11 L-\, _ 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 TYPE: PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID #: 2q-3(2- Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: Lot No. — Block No. Additional work to be performed under this permit —check all that apply: _Mechanical _ Gas Tank Gas Piping _Shutters Windows/Doors Electric — Plumbing _ Sprinklers — Generator ^ Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ 500.;!)�D OWNER/LESSEE: Nam 4_ f Sq. Ft. of First Floor: Utilities: Sewer _Septic Addressffz212e:.1-4 .— City: ~ i���CC Stater. Zip'Code:r3S��i / _ Fax: Phone N0. 2 — U— �6 7 6 E-Mail: a 19U1— F Fill in fee simple Title Holder on next page (if different from the Owner listed above) CONTRACTOR: Building Height: Name: t-4kb2"--Jc 4C A/n2-2 Z Company: tt- 610zVC C-- Co bt4r2f42" 446 Address: Sw, 1-'l�C. auC'a/ fiver City: -State: <rL Zip -Code: _3y2S3 Fax: Phone No 77ZSZ8�7ZS8 E-Mail�j State or County Licensee if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTR CTION LIEN LAW INFORMATION: a..._R__i�!_ ©ESIG 'El JENGIREER: ,iot Applicable MORTGAGE COMPA�vY: � IVOL AppilCabie Name Address: Address: _ City: _ State; _ ;City; _._. - state: Zip: _ Phone._ FEE SIMPLE TITLE BOLDER: Not Applicable 'BONDING COMPANY: _ of Applicable Name: _ Name: Address: Address: City: City:- Zip: Phone: Zip: _-__�_-. Phone: OWNER CONTRACTOR AFFI®VIT; Application is herebyeby 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 wilt authorize the permit holder to build tine subject structure which is in conflict with any applicable Home Owners Assoc[ation rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for ally 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." .112 Signature of Owner/ Ives' .e/Curitractoi as Agent for Owner Signee'atur�ofCo`n�tor;L�iense lol STATE OF FLORIQ STATE OF FLORIDA COUNTY OF COUNTY OF�,Lc/C The rolgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this Q tI day of fib -� 20AB by this_ day of +ay 20A by Name of person making statement. Persona!!y Known OR Produced Identification Type of Identification Prodiirpri (signature o to 3FPie *0111111111111 9$H00M t Commission No. , + CWMs#kM; '„ , ''f I7fuu'rrertr�liwa REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED COMPLETED Name of person making statement. Personally Known OR Produced Identification Type of identification Produced ,-_-_--_ .. {Signature OT Notary Commission No. 6�3n# GG 230D4 Expires luna2#t lorded TMTro I `fin urx�ce SUPERVI50R PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW l REVIEW REVIEW REVIEW