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HomeMy WebLinkAboutBuilding Permit Application i ALL APPLICAB INFO MUST BE COMP ED FOR APPLICATION TO BE ACCEPTED Date: L' 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 PROPOSED IMPROVEMENT LOCATION: Address: �tC �SO1'1f�lGle. Legal Description: OkLndff P� k,T Lp htk V4 G3 Ld.aab Al(09,3L g•a��l �1°►°1 ��ck�:�se� 1-ea�xc-� Property Tax ID#: 106 • O©DLI • 000• <� Lot No. Site Plan Name: % Block No. Project Name: C-4 Setbacks Front Back: Right Side: �� Left Side: o2 3 y DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional work to e nertormed under this permit—check all apply: LJHVAC 0 Ga's Tank Gas Piping Shutters Q Windows/Doors ®Electric ® Plumbing OSprinklers OGenerator Roof ;Roof pitch Total Sq. Ft of Construction: 3-7 S . Ft. of First Floor: Cost of Construction:$ 3 3 j�� UtilitiestnSewerE]Septic Building Height: OWNERAESSEE: CONTRACTOR: Name Name: Address: —r 1 � Company: � ,' City: State:- Address:t�D.-6 IOUDtX(y UXCQ� Zip Code: Fax: City: City: State: Phone No. Q �S`"�a-0`G Zip Code:':j; t�0 F :C�( ZPI •a3q;L E-Mail: Phone No.l!'1l��yl�l�l •$IQ Fill in fee simple Title Holder on next page(if different E-Mail: • C,Lt� from the Owner listed above) State or County License: `5 S If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Fro m:Amer l can-pools 407 847 9342 04/12/2017 01:53 0348 P.002 I)ESIGNER/ENGINEER of Applicable MORTGAGE COMPANY: .�,Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: i,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.Lucle County makes no representation that is granting a pefrnit will authorize the permit holder to build the subject structure which is in conflict with any applicable Horne owners Association ruler,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. accessary structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your fallure to Record a Notice of Commencement may remit 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 attomey before commencing work or recording our Notice of Commencement. aop Vj — _ s ignature Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID STATE Of FLO l�bA n 1 COUNTY OF "4 �� COUNTY OF F'�-�U The forgoing instrument was acknowledged before me The forgoing instrument wjs acknowledged before me this_day of 20 _by this 10 day of ZO 1 by W tt {Name of person acknowledging} Name of person acknowledging)- GC/L. (Signa Notary ublic State of Florida) (Signal of NotAy Pubflc-State of r a) Personally Known OR Produced identification Personally Known OR Produced Identification Type of identification Produced Type of identification Pro ueed Commission NCr*ErXnrrieB- ea Commission No. (Seal) Mwepy gun STATE OF FLORIDA iilltl►rARY PLI ft WORM— . i Revised 67/15 4 Expil"5ra=20 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE coMPi.ETE INITIALS