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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u U Date: l� O Permit Number: R E C E I'.'^D MAR 212917 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 PROPOSED IMPROVEMENT LOCATION: Address: (�o s . nmi an Legal Description: Property Tax ID#: - to I 0-ci( . - ©od " Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: ono -4- NIUMOV O-0 Cb "Lq2 V_ _RG+hluWP1\ vl n►�9US �oYe -} e�p►a���1 ��� i r) VY)&n 1�Yi►_�06 C, \�-.o. CONSTRUCTION INFORMATION: Additional work to e nertormed under this permit—check all apply: ❑HVAC Gas Tank ❑Gas Piping In Shutters . Q Windows/Doors ❑Electric ® Plumbing ❑Sprinklers ❑Generator ❑Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ ' �t Utilities: Sewer❑Septic Building Height: OWNER/LESSEE: CONTR TOR: Name e &+g(1 Name: Address: (6,'F_ J• ( -:�q OY Company: 1 City: Q'l��Q P'l 'LA P/1 State:_ Address: ?) Zip Code: 3_1q1� Fax: c�-�, City: State pq— Phone No.Co(S 55q - g`� Zip Code: 0 Fax:q gZ-251-6 E-Mail: Phone No. _?'Z' 8/ — 5v 02 Fill in fee simple Title Holder on next page(if different E-Mail: los from the Owner listed above) State or ounty License: C �� I If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable e: _ am Name: Address: P94I.Gr- S� 1��< <._ / v, �'�. Address: City: 0,�j�- —� State: l_ City: State: Zip:3�4 jq!1 Phone: '?:2. _���qq� 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, gprLsult with lender o an atto ey bef re commencing work or recording our Notice of CommenceplEent. s Signature 6f Owner essee/Contractor as Agent for Owner Signa ure ont a for/Licen Holder STATE OF FLnR1PA _ STATE OF FLQRJDA COUNTY OF COUNTY OF M(;Z-FIO, The forgoing instrLimenit was acknowledged before me The forgoing instf ument was acknowledged before me this day of 20(4by this ofM1 � by - ArC) (Name person acknowledging (Name of on acknowledging) o NT51gfiature of Notary Public-State of Florida) (SiEn-a�tilre of Notary Public-State of Florida) Personally Known I is io I� Personally Known R ro -W Type of Id ntQfi0%U ,Produ Type of Identificati n P;pd-uqd Commissi o, ;._ Notary Public-St lorlda �: :°:z Notary Pu �ytale of Florida E5If Commission No. Comm. xpul8s Jun 21,2018 :N, °�c mn..Expires un 2 2018 Y Commission#FF 106794 •'•:,',fo�r.�':•� Commission#FF 106794 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS UZ