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HomeMy WebLinkAboutBuilding Permit Application � r ALL APPLICABLE INFO:MUST;__ COMPLETER FOit:A 00 *TION;'0 BE ACCEPTED Date him ` : 1 Permit Number;_..1 - Buifd ng Permit Applicat do Planning and.-DevelopmentSeriices j Build3ngjanr�GotleRegulutron'Divhion1 Z300 Vrrg�n�a Av�nue,"Fort Pierce F!34982 Phone. (772}.4621553 Fax (772).462:a5.78. Commerci7.al JResldentlal PERMIT APPLICATION'FOR: Roof 1p t� .Address j�•`l�`fir' � ! ' krl�l�'��lV�', �}����-Y--����.. r :. Legal Description - `PraperLy Tax :Site Plan Nare: _ _ -. Bloc.k No ;Project j Setbacks Fro6tA2' F Back Right Sine __ Left Side " aka, ">.'sa# ; : - DETAILED DESSCRgITI®: 1,a'1✓ WQR , X� Mla ; CON-STIRUCTI4N INEOR�M , 'tfJN,. .b itiona wor to,_:e a:forme k-pup er t is permit—,_c ec,;-.a QF]- app HVAC LJ Gas Tank ❑Gas Piping _Shutters a-Windows/Doors aElectra; ❑Plumbing;, Sprinkfers °Generator ®Roaf Roof.`pitch , 66(l'5 Ft�of Construction; S .Ft of first Floor: Cost of Construction:$ q1 A"t` Utilities Sewer, Sepfrc' Bu�Idmg,Height.t ---c - - -- iv O NER�LESSEE; �� R D ACTT© Name jAddress �� �� ..1 ? t(;l-Y1' tUE7ir tia � ' Company l° _ - _ I Gty_" State Address _ ,�LL Pe; Zi .Code Fax :City. State Phone No Fax E=NIai1 i�f7)�C'f�CK1r1P�1 Q �.,�{ ,R_hone No 2i "�� Fill h Me" impleTitle Holder on next page -if different. E=Mail_ ` f nuthe-Owneriistdd above) State":orCouniviLGcense If value of 6strucbon h$25t)0 or more,.a RECORDED Notice of commencement is..°required,. � t � 0. EMENTAL-CONSTRUCTIO:N 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 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. I - s Signature o Owner/Lessee/Contractor as Agent for Owner Signature o Contractor/License Ho STATE OF FLORIDA STATE OF FLORIDA COUNTY OF yx I (' COUNTY OF i The for oing instrument was acknowledge efore me The forgoing instrument was acknowledged before me this�day of �Q� 20 t�by this J-A day of\)[J"A U&Lf" ,20 by (Name of person acknowledging) (Name of person acknowledging) I (Signature of N aryPublic-State of Florida) (Signature of Not Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Q Commission No. lj (Seal) Commission No. LA L.C,�--(� D (Seal) Revised 07/15/2014 � MY COMMISSION#FF920758 MY COMMISSION#FP920756 A ,. EXPIRES September 22.2019 ='� .' ',tea EXPIRES September 22.2019 \ 1407 3 8 1401)398 'b3 Flcvklallotery orvke.car: ' REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE IF COMPLETE INITIALS