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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED g Date:— - ! Permit Number: ! 103-07 609 4111111111 Building .Permit Application MAR / 1 2017 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: PROPOSED INPR01/EM'fNT LOCATICt3'N: Address: /6D'/ Legal Description: Property Tax ID#: ! a 5 tea/ - dUQ� . t9 - Lot No. Site Plan Name: Block No. Project Name: ('O ZA IDo IJ-e- 40-a C_ Setbacks Front Back: Right Side: Left Side: DETAULED DE�SCR+SPTON OF WORK: 6OR-t)y C©'NSTR�UCTICo7N I�N�RQRMA 1©N: iti nna wor to ape orme 6nder 10 permit-check a t at-appy: _Mechanical _Gas Tank _Gas Piping Shutters Windows/bobs, i _Electric _Plumbing _Sprinklers' _Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Flodr-: ; Cost of Construction:$ 20Bd Utilities: _Sewer _Septic Building Height: ®WNPROWNWEE: NOW ffil TQR: Name 'ArWUS Name: Address: /044F SAC)'--e 4_)'YIws br- Company: City: !7-, t�«�cei State: PZ_ Address: Zip Code: Ie1 415F Fax: City: State: Phone No. J/Q ' 96-2 d yS- Zip Code: Fax: E-Mail: I i--yr--3 n No Fill in feEVmple a Holder on next pa (if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Sl1PPLEMENTAL C®NSTRtJCTI®N L1'£N LAW INOfiMAT'1OS 11 : 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/Lessee/Contractor as Agent for Owner ,,a :•r�n ure of Contractor/License Holder STATE OF FLORIDA E OF FLORIDA COUNTY OF NTY OF a � The forgoing Inst ent was acknowledg d efore me g� orgoing instrument was acknowledged before me this 1 day of i 2047 z I day of 20_ by Om wR= g (Name of person acknowledging) a of person acknowledging) (Signature of No ry Public-'St-ate of Flori ra V (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014 I