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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COM TED FOR APPLICATION TO BE ACCEPTED- Date: 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 APPLICATION FOR: �an � - vrc� PR®POSED N�PRO�/f� FENT LOCATICIN-: Address: J� )d"3 a 1 Legal Description: Property Tax ID#: l �-I�l J l✓ I �'1 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 4749 DET� ILED � -C 41PTI0N O.F 111/OR� - DES CONS�TR�l1CTION FN�F� R�M:A�TION: 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: Sq. Ft. of First.Fibat: Cost of Construction: $ Utilities: Sewer _Septic Building Height: 01N'N'ERE�SSEmE CONTR CTO�R: Name A holl XI © I Name:- Address: Company: City: LQ� LAL> State: Address: Zip Code: Fax: City: State: Phone No. ��)) — Zip Code: ZFax: E-Mail: 9,Af� I ) F`i 8c2)-f'1 6 HA Phone No Fill in fee simple Title Holder on next page (if different ; E-Mail from the Owner listed above) State or C unty License If value of construction is 2500 or more,a RECORDED Notice of Commen ement is required. AL SUP'FLEMENTAL CONSTRUCTIwN LI=EN LAUD INF®RMATION:: _ 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 Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ��� �. GI �-- COUNTY OF The forgoing instru t as acknowledge efore me The forgoing instrument was acknowledged before me this a( y of 20 by this day of 20_ by (Name of person acknowledging) (Name of person acknowledgingC)V\,C\,& ) i (Signature of Notary ublic-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificat' Type of Identification Produced Produced ,, 9 otPR PUe ANGELA M HUFF Commission No. Notary p0IhZI)State of Florida Commission No. (Seal) ?= _ Commission#FF 234730 ,N np�j My Comm.Expires May 27 2r. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE 3 RECEIVED DATE COMPLETED Rev. 7/2014