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HomeMy WebLinkAboutBuilding permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIONTO BE ACCEPTED Date: Permit Number; Building Permit Application Planning and Development Services Building and Code RegulaNnn Division 2300 Virginia. Avenue, Fort Pierre FL 34992 V/ Phone: (772) 462-1.553Fax; (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: Legal Property Tax ID H: tot No. Site Plan Name: Block No,.. Project Name: Setbacks Front Back: Right Side: Left Side:. \0.�e, � doors -to tea" P -�NSfRWC"CICJN INFO(iN�IATIrJP): Fdffjtjiodd' natwor)<fob�orme unertuspermiT=CICCkat'apply; "- L IHVAC OGasTank ❑GasPil g _Shutters Windows/Doors OElectric OPlumbing 05prinkiers Generator E3 Roof= Root pitch TotalSq. Ft of Construction: t1 S Ft. of First Floor: Cost ofConstr.l iq uctlon:$ - }r!� • Z"I utilities Sewer Septic Building Height:..P�lt et c1,U�NERI!-E55E�.r fr 4 �i if value Name Namex,.�rASOn !jJmrh ql Address:41 4go S , kQc.lt Ar• l col Company: Wq.T Dcnr A City: - t'hS�li- gea.C4� Zip Code: Llg67 Fax: Phone No.J5i(o - R r /8' i 6 O State: Address:Zi4f Dr. sr('e-• City _xJV)I�Cf T State: Zip Code: df$ Fax:. Phone No. - r / 8 E-Mal I:�� S�i� fn+� ©0 k Fill in fee simple Title Holder on next page from the Owner listed above) Gorf's (If different E-Mail: Q�fYx i=c* c State or County License; ac ? of construction is $2500 or more, a RECORDED Notice of Commencement is required, Name Address: City. State: _ _ Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone; MORTGAGE COMPANY: Name:_ _Not Applicable Address:' City: Zip; Phone': — — State; _ BONDINGCOMPANY: Name; _Not Applicable Address eiky; 2fp: Phone: I certify.that no work or 1nsWRation has commenced. prior to the)ssitance of a permit. build the subject structure may restrict or prolUlt such u which -may apply. In tnnsiderationof the granting of this requested permit, I do hereby agree that I will; In ail respects perform the work In accordance with the approved plans, the Florida nuilding Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a fullconcurrency review: roomadditions, accessory structpres, swimming pools, fences, walls, signs screen rooms and accessory uses to another non-residential a Notice to obtaIn Signature Own /Lessee Contraetoras Agent for Owner STATE OF FLORIDA COUNTY OF Sr L uu h Thq forgoing instrument was acknowledged before me tnls � day of ,. Alb c 6'4 . 20 Z � 6y It in your paying twice for i and posted on the )Obsite or anattorney before The forgoing Ins ument was acknowledged 6eforem'e this �Qday of�,,.,,,__., .(Name of person acknowledging) (Name of person acknowledging ) (Signature of Notary of Florida Personally Known li OR Produced` Identification Type of Identification Produced Commission No, Revised 07/d 5J2D t4 rF (Sgnatur� a of Notary Public- ;. to of Florida ) Personally Known OR Produced Identification -'type of Identiflcatlon Produced (SeagLLIAMLGLOVER Commission :No: Commission R G0 34333E REVIEW$. FRONT COWNTER ZONING- REVIEW SWPERVISOft REVIEW PLANS REVIEW 'VEGETATION REVIEW SEATURTLE REVIEW MANGROVE REVIEW .DATE.. COMPLETE... INITIALS