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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB E INNFFO, USSTT BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 1 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: To Select from dropbox, click arrow at the end of line PROP®SED1'NI�PR,�®�1�/�EM �IT LOCAT�ION�:; , Address: y 7 _T_�k Prnp I"I Legal Description: '1 �- 2,01C 641 44— Of 04f� I-C- 4� 4c_t Property Tax ID#: 1-31 2- ` '701 Oo& '7 ©D O - D Lot No.�_ Site Plan Name: Block No. Project Name: /3e L f¢61 i tS��f't5 Setbacks Front Back: Right Side: Left Side: Dl_1'AILE® DESCRIPTI®N OF WORK � .. Will. d n ® r; Iry os CONS�T,RUCTION IN'F®.RlN1A�TION: Additionalwork to flGasTank r orme un er t is permit—c ec a app y: ❑HVAC Gas Piping _Shutters Windows/Doors Electric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor;, Cost of Construction:$ y� Utilities: —Sewer Septic Building Height: 70®1tItER LESS: E a z M a _ C'fOR: � a t e Name M. Address: l Y f -� f' r'�J ��ct Company: City: /o✓.f- !`�i'�� Stater Address: Zip Code: 3l/�.1 l Fax: City: /—'Sl/ State:JC Phone No. Zip Code: � �lei Fax: rJ E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: Zd. If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Sl1PPl.ENi�ENTAL�CO�NSTRi1CTIONI.IEN L:�►UU IyN°4=ORIVIA�'ION. � �°J �.;,,��� � �,�, � x.utter '�d:-{ - .�� �. ,A �..x+- 4 .asks-: - .t.x.> .a• t x .. �;,n. � ",a � a '"`"° �: �# DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: yNot 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. �0� �":�� s Signature of ner/Lessee/Contractor kent for Owner Signature of C tractor/License Holde STATE OF FLORIDA STATE OF FLORIDA COUNTY OF _� COUNTY OF The r 'n instru �t w cknowled a efore me The forgoing instrume • as acknowledged before me thi ay of 20 y thj day of 20 Mby �_C57\ Z_Q� (Na a of pe on acknowledging (Name of per on acknowledging) ANGELA M F 1p e ry po I tat of Florida F ra I i �� vn ! (Signature of Note 9•uj o-$#altt�6��18r �l�es (Signature of IVY' ry5 _S�f&;aE Qc HUFF s o through National Notary Assn. fate of Florida Bord d Commission( � y Pn;:Cl1 Mv,0i�c�f�i( e�ti F t Bn Personally Known:.4-' ^'=��"OR Pro uce Identification Personal) Known' F , .,, s Type of Identification Produced Type of Identification rodU&4edlhrni I,III—_ aY 27,20;9 ' Commission No. (Seal) Commission No. (Seal)- Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIE REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS F s , 1 feet k ie Earth meters 310