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HomeMy WebLinkAboutBUILDING PERMIT APP-UPDATEDAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: t t2 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: "PAR iPt ED, YN?t Q E(VI ENS'VWlai Address: 9 'Q / M Legal Description: //) z r1A--- Property Tax ID ##:�a 1 (� ��� (� Lot No. Site Plan Name: / Block No. Project Name: t ldrs l� Setbacks Front Back: Right Side: Left Side: CC3NSTRUCTION NFORi1WO Additional work to be pertormed under this permit— check all that apply: _Mechanical _ GTank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ _ t Generator _ Roof Pitch Sq. Ft. of First Floor: _ Utilities: —Sewer _Septic Building Height: �vvNE.ESSEE� Name d t- k e— Name: ir- Compan` . Address rn i f—, City: State: C'�--. Address: c Zip Code: 2-4_Q Fax: City: � e'r'C.,rL State: Phone No. _7`%�' -� .j�F.. ,_ �"�C�` J Zip Code: c_�qq &-a1— Fax: Phone No E-Mail:= 1 1 C1 t Ct6 _ e,Gvz­o, E-Mail ! ef ej% C% Fill in fee simple Title Holder on next page ( if different State or County Licensee o-7C. L?,S - ff © L from the Owner listed above) It value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION I.iEN LAW INFORMATION: RSIGNERIENGINEER: Not Applicable Name: - MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: _ Phone: FEE SIMPLE TITLEHOLDER: Not Applicable, Name: BONDING COMPANY: _Not Applicable 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 Count, 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 wort: 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 JOB SITE BEFORE THE FIRST INSPECTION, W YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT--" Signature of Owner/ Lessee/Contractor as yet for owner Signature of Contractor/License Holder STATE OF FL COUNTY OF STATE OF ORIDA14 I AI Li e- I COUNTY OF ORICiA5 The forgoing instrtA ient was acknowledged before me this _day of tl—Dr 20cj by Name of person making statement_ Personally Known OR Produced Identification Type of Identification L. Produced r. j I , t (Signature of Notary Public- St L 1 wv a0*w� Notary Public State of Flontl+ n f' sa L 9uikr�std Commission No. �'; :ilr�(�l . �(5 amrrauion GG 302085 . �'or}to" cx,nrest)2t14t2023 � REVIEWS ( FRONT I ZONING I COUNTER REVIEW DATE RECEIVED COMPLETED The forgoing instrument was acknowledged before me this day of y'/isf 20 w ll by Name of person making statement_ Personally Known OR Produced Identification Type of Identification Produced i � natbre of Notary Public- State of %Iei=55a L Bu'fe'rf mission No. :{ice 7 eal}M os n PNS EATURTL ANGROVE SUPERVISREVIEWOR I REV EW I VREV EWON 5 REVIEW E REVIEWW