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HomeMy WebLinkAboutBuilding Permit Application I All'APPLICABLE INFO MU BE COM, ED FOR APPLICATION TO BE ACCEPTED Date: I� Permit Number: I I ..��- "iiax- �^ � ,p-rtm•;:tea-. .wur ,v y z�_ 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: - Address: - T Legal Description: L. f Property Tax ID#: (� �) — Lot No. I l Site Plan Name: -:• -. ( `1 1 Block No. Project Name: Setbacks Front Back: Right Side: 'Left Side: III-- ��DETrP31M.0211 D4E ,@ lP TI'QN QFVUO'R7C eo`NslI `` -1 � I INFUR�AT10 +« a�i �: �,-_...-.-fig � �: s ._ _ _ WW; Additionalwork to be pertormed 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 Floor: Cost of Construction:$ C_1� Utilities: _Sewer _Septic Building Height: 01NRf E� COIVT ACTR;� Name \ Name: Address: 12)_A\ Company: 1 1 City: Q, .l;\ Sl Stat Address: ZipCode: F� Fax: Cit �•� (--� Stat Phone No. a `a.l (r) Zip Code:1u _� Fax: '17-A E-Mail: Phone No `a L�(D 0 c�9u Fill in fee simple Title Holder on next page if different E-Mai , la (1Z.Q d a Qom_ from the Owner listed above) State or County license_01—C © (0 S If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S IPPLEIfENT :L ®N'STRaUCTI.O,N LIEN LA�1N INFORMATIaNr. . 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 an attorney before commencing work or-reGQr_ding your Notice of Commencement. Ne'�_ Signature of Owner/Lessee/Contractor-6 ent for Owner Signature of Contractor/Lice olde STATE OF FLORIDA � STATE OF COUNTY OF FLORIDA �� , �_ G COUNTY OF ( L—�X C� ,� j, �. The for instru en w ac owledg efore me The f r ng instru ent was a.knowledg fore me this�y of \ T 20 by this day of 20 1 y (Name of person acknowledging) (Name of person acknowledging) (Signature of )ry Public-State of Florida 43ignature o tary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of(dent i t o. Type of Identifi ti n I _ � �Produced f: "" Pro- ° .°. ANGELA M t-� „ _ �: ANG A M .'(Seal) 4 = Notary Public H1JFF ;Cb fs N EL HUFF Commission No`� - ( of - "r1 �' c. Fl N1 mission# orida �,t „ Com State of Flo Y Co or missio Florida M mm.Ex it FF 234730 i,OF FjOpP MY C n FF 23 1 0 Mrou, 9 ,,_ Bondadthr... �hNatrona)N t3� " ;. resMa P7 20 REVIEWS FRONT ZONIN& -����`;5ylg' RVISOR PLANS VE ET °al o TLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW E,VI W REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014