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HomeMy WebLinkAboutBuilding Permit Application 'ALL APPLICABLE rFO MU T BE COMPLETED 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: To Select from dropbox, click arrow at the end of line RAC - AX w PRCIPCISED LML R©UEM'ENT LOCATIaN: n Address: '! © �si }"�Y,`i�n. , oxFI. f1C�2Ge Legal Description: Lk-2ZA 23 Property Tax ID#: Lf n'bz3 —Dvy-- : Lot No. 2 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Sider Left Side: DETAII.E© DE�SCR(i TION C1F WORK: Aln- &Oyr•I ia►oinq f sy��� Lh�zife�)>-,c A I L P C®IUSTRUCT0N N6F®©,RLVIATION: Swor to ewer orme under this permit-check a apply: VAC_:, _Gas Tank Gas Piping` _Shutters Q Windows/Doors Electric ❑ Plumbing USprinklers J 1:1 Generator E Roof .Roof pitch Total`Sq.Ft of Constructio S . Ft.of First Floor: Cost of,Construction:$ � . Utilities: SewerSeptic Building Height: OWNER/LE-SSEE: CONTRACTOR: Name ZY)) D f) Name: 7s-,r Address: [? lrlll G� Company: k6n 2-A//L- G City: F I i j�'1 AC--t- State:.4!�� Address: A�v> t�+r Zip Code: Fax: City: gs L, 'State:4_(- Phone No. - 7 2- 4 6S' 6 Z I / Zip Code:,2i� �b Fax: ' 92 Z/ -OVZ' E-Mail: Phone No. 7 7 Z- LQI Fill in fee simple Title Holder on next page(if different. E-Mail: -I.CYY12A Z—,(g--Ie /y from the Owner listed above) State or County License: GA ej e/ z3K3 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SU ,RLEMENTAL CONST�lt1CTI�N LIEN LAW 4N�FOR�MATIO ' : ' 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. s ignature of Owner/Lessee on ractor as Agent for Owner Si a ure of Contr ctor/Li ense older STATE OF FLORIDA STATE OF FLORIDA COUNTY OF _Z COUNTY OF The l oing instrum n I was acknowledge�ifore me The f oing instru ent was acknowledgic fore me this �� (day of 20 y this day CkC 20 '' ((by ( —ame of person acknowledging) (Name of person acknowledging) (Si ublic-State of Florida) (Signatu'e4of otary ublic-State of Florida ) Personall ' aYP � d11dld jdenti i lion ersonbli y` 'n Q t Identification ype of Identifi' oh- r 7j�irP�j3tio State of Flnrrrl A M H ' * , ; * •; commission#fF 234730 / 'a, ``` ° •, C0 I o Y Com } '%rn ado mmissio tale of fl rl F `a PA m.Ex Tres �•_ „ MY Com n#FF r. Comma ion'-l�for" p May �9 Commission'N'o. nsf� m F, 2347 ationalNotaryAssn. c,,�,throughNata/Not, 20ig' - � all. Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVI W J REVIEW REVIEW REVIEW DATE 3 COMPLETE J / INITIALS