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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r Date: 1 ��- �d A Permit Number: �Cno' J It FionMAY WE)Building Permit Applica2 0 2020Planning and Development Services nty, Permitting 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, W UP•M P . O E ENT OC •N: Address: go Sr d f� " (IV J� Legal Description: a7- 6_Y1 Property Tax ID#: Lot No. Site Plan Name: Block No. �b Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DEx mpff M WL WOR . R v� CS-t-� -r �.�s� r� '/a 3 f3r)R 0A1 Cam CJS CONSTRUCTION t FORMAT(ON: Afffti-o-nfal worK to De pe orme un ert is permit-c ec a tat appy: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors Electric —Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: -9©® Sq. Ft. of First Floor: Cost of Construction: $ l do•(9(/ Utilities: —Sewer _Septic Building Height: OWN R MNSEE: CO TRACTOR: Name. v c '.-/ Name: (s. Address: ��� 5 /V C� i(� s�S I--V Company: City: o R 7` P=f e?-CP— State: Address: Zip Code: _? q9J/ Fax: City: State: Phone No. g 3,1 (0 3- Zip Code: Fax: E-Mail: Z -DF-) _ P����S %P L61- i"'4 yLi ►'Phone No. Fill in fee simple Title Holder on next page_(if different E-Mail: from the Owner listed above) State or County License: If value of construction is 1500 or more,a RECORDED Notice of Commencement is required. St�PPlE ENTA CONSTRUCTI©N LIE W INF(!3RMATION. 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: OWNER/CONTRACTOR AFFIDVIT: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 our Notice of Commencement. Signature of Owner/Agent/Lessee/Contractor Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Sk COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this–,kb day of V\N 20-ati by this day of 20_ by �6"'y V`tiar�� .n (Name of person acknowledging) (Name of person acknowledging) (Signature of Notarq Public-State of Florida) (Signature of Notary Public-State of Florida ) Personally Known OR Produc —" Personally Known OR Produced Identification Type of Identification MARIEGNSNS Type of Identification Produced S MY COMMISSION JIG Commission No. EXP1 ttt x16,2020 iters Commission No. (Seal) �':'f,dFi�Yp'• edMO Notary PuAlicUndeiwd REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 3