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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 31 a$ l—I 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 �cn'C' � PROPOSED IMPROVEMENT LQCATIQN Address: $W US 'F LOrer\C e 0r. Port Sa i nF k_uci C_ t=L 31A ASa Legal Description: LA Y_-,LA0na `lit-ci Cpvpe_Y-c0-iye clr\it Lot ag or a(?oa- Property Tax lD#:_ 34aU- U Lotl-(0o9-1-0cc0-3 Lot No. 9'9 Site Plan Name: Lk PSUOnCk Vita Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE CRIMORO, F VtfORK T6 -Vcar Oq eXsis4;,�q shingle rood and lhstall SyrtfilneA-ic �6 c4trIa me -T gncl Iricstall 6d crtrnq m ta1 ra,f S�s¢ern �XSist�nq deck to rennc�in. �`i1 5 CONSTRUCTION tNfORMATIONAdditional . ❑_HVAC work to be performed Gas Tank un er t is Ga Pi Inpermit c-check a _Mptters p g ❑Win dows/Doors Electric ❑ Plumbing Sprinklers Generator © Roof Roof pitch Total Sq. Ft of Construction: )LD 00 S Ft. of First Floor: Cost of Construction:$ LPZ�,®O. oo Utilities: Sewer Septic Building Height: OINNERJLESSEE„ v C CI"ONTRAOR r ��_ Namelhornas curl V�>o•nhca &Acc,0�P S Ki Name: k l 2 62-i%c Address: SUS Florcnce. pr• Company:�i.0 it CJ City: Vcrt Saa�n-v Lucie State: (=l. Address: 170i( K6� r 'zi L M Zip Code: 34g5QL Fax: N IN City: dfO St L State: Phone No. Zip Code: 3Y6 5 2 Fax: A.-' 'c1 E-Mail: N (P, Phone No.. 77� r7 9 YS.q2 Fill in fee simple Title Holder on next page(if different E-Mail: 'et from the Owner listed above) State or County License: ;?q/o '7 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFOWATI�N' 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 Signature of Owner/Lessee/Contractor as Agent er Signature of Contractor/License Holder STATE OF FLORIDAS� l I ' ��� STATE OF FLORIDA COUNTY OF C—, L1` COUNTY OF U� The for in i t irrIerlt was acknowled a ore me Th ring instru ent was acknowledg d fore me thi7tk� day of 20 thi day of 20 1 nby (Name of person acknowledging) (Name of person acknowledging) (Signature of Wary Public-State of Florida) (Signs of Notar Public-State of Florida ) Personally Kno ion Personally Known OR Produced Identification o I en�t�, a ton roducgcligELA M HUFF Type of Identificaattio rodu e c �Ppy PUB% 1 ,b °�-- Notary Public-State of on a ANGELA M HUFF Co miss! t,A0 .= Commission#FF �� C Commission'.Nq°" Y P�°� ublic-Stat�� brida My Comm.Expires May 27, G19 =• •= Commission# FF 234730 of c�°p A through National Notary Assn. Nqo .o`; my Comm Expires Ma Bonded through National Notary Assn, Revised 07/15/2014 - REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS