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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l� Date: Permit Number: s 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 APPLICATION FOR: To Select from dropbox, click arrow at the end of line PR(JPOSED I�MPR®uEM�ENT L�CATt®N�: Address: 1 t� j Legal Description: Y \ tnl= 2a Property Tax ID#:21L e7-��p/ ,�/� "OD�' 1 Lot No. Site Plan Name: I I1 (^C`� I - ftMIA—, Block No. ProjectName: .Setbacks Front 'Back: Right Side: Left Side: DETAILED DE�.SCRt!PTl®N Ot=WORK: CONSTRC7CTI:ON I!N -ORTI©N: Additional work toa er orme. under Tis permit—check a appy: HVAC F]Gas Tank []Gas Piping _Shutters Q Windows/Doors DElectric ___Plumbing Sprinklers FIGenerator Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ �U Utilities:�Sewer Septic Building Height: �01 ,lNER/ALE�SSEE: CONTR CTOR: Nam,- Name: - ' AddrietlAas tr Company: . Gity 'A A 1101? �,:r�,a� ,.� = Stat A Jdress:.<.. LA ip` ode'' U: y ; ..,.Yeo �S�,X.aP`,, • ,y` Sta ;F# fir, •to . ' P Fax: E-Mail: - Fill in fee simple Title Holder on next page(if different E-Mail: ) o 04 W-00 from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement-is required. PPLEMEI AXI CO S�fRt1' IDN LIEN �1M INFQRNf 4 I®.; Id*-Aq 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. • s 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 wcIlk-of-recording your Notice of Commencement. --—� �_ . S Signature of Owner/Lessee/Con ra or as gent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20 _by this day of 20 by a cx—, (Name of person acknowledging) (Name of person acknowledging) igrl of Notary Public- tate of Florida) (Signature of Notary Pu ic-State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced -fk\" � 1IQS'p. n1,3: 55.oub- -0 Commission No. (Seal) Commission No. ;`i►A�P�s,, MA��I���PAUL7ARIAS Notary Public-Statidavssy 6Je)nN IeuOgeN g6nayl Papuog. (' ' Commission#GG46l �� # UOISSIWW03 �a0 � 1iq/f1�1t1�`'r Xp res 021Revised 07/15/2 }4oaasandx3'WWop�Wa Banded through Nationalasa. EP!10]j to aleIS-311gnd AJL'10k. .'s,o ti WVU N REVIEWS F OP R S R PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Date: Fee DI 'ermit# r St. Lucie County Building & Zoning i 2300 Virginia Avenue rt.Pierce,Fl,34982-5652 Tel.561-462-1553 SPECIALTY PERMIT APPLICATION FINAL FEB 21 2017 C1 Electrical 0 Plumbing El HVAC ❑ Fence PER-HITTING 0 Shed 0 Demolition El Gas 0 Siding SL Lucie County, FL Seepage 2for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 1 6 o 2. Parcel-ID Number: 314 (4 -5 L4 0 Office hi Towns� ---- e Ma 'I Section Rang P Page I Zoning I Lanct Use nitials 3. Description of Projector Work Activity: SOLAR POOL HEATING SYSTEM 4. Owners Tnfor ation 5. Contractors Information Name: P-A FL Reg/Cert C.FC0980 68 19738 k &AUUA- C) County Cert#: Address: I , City: l.. State: Business Mame: TRYON PLUMBING INC \13 Zip: Phone:'?')�, Q)&<-�C%One 465-0284 Fax 465-0187 6. Value of Construction: OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct andthat all work will be done in compliance with all applicable laws regulating construction PRINT QUALIFIERSIOWNERS NAME SIGNATURE OF QUALIFIER/OWNER STATE OF FLORIDA,COUNTY OF ACKNOWLEDGED BEFORE ME THIS I, DAY OF tO BY WHO,IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS IDENTIFICATION. (sea]) SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY TITLE: NOT.-1RY PUBI-I COMMISSION NUMBER St.Lucie County Specialty Permit Application rev.9125/05 dmg