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HomeMy WebLinkAboutpermit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I I % al — Permit Number: Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED INPRO EMENT LOCATH Address: Legal Description:} Property Tax ID #: Q � � 0 tl "n Q (41 1000 2 Lot No.1-7_ s. d Site Plan Name: _�1; Q__��� e- i (—V.5 Block No. Project Name:. iro Setbacks Front Back: Right Side: Left Side: D€TAILED [ESCRIPTIQN QF U1fC)RK CC}NSTRU�T1flNiFQR#1�[ATIC}1..... Additionalwor to be perTormeo under tis permit —check all tat apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters _ windows/Doors Electric .t��/Plumbing _ Sprinklers _ Generator ` Roof Pitch Total Sq. Ft of Construction: , Sq. Ft. of First Floor: p Cost of Construction: $ ` C)o Utilities: —Sewer —Septic Building Height: \ C T CTOR. flvtr�IEI�.E �Eca Name. r Name:' " © 1 Company: Address:6 City: Sta Address: Zip code- Fax: City. St t Phone No. 3 Zip Co :�� Fax: E-Mai (� Phone No�7 Fill in fee sim le Title Holder on next page ( if different E-Mail ,17 • Cd from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW IN 'DESIGNER%ENGINEER: Not Applicable Name: ` Address: City: State: Zip: Phone FEE SIMPLE TITLEHOLDER: _,___ Not Applicable Name: Address: City: Zip: Phone; ORMATION. MORTGAGE COMPANY: Not Applicable Name: Address: City: State; Zip: Phone: BONDING COMPANY: Not Applicable Name: Address:' City: Zip: _ Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicatea. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Coupttfyyi makes no representation that is granting a permit will authorize the permit holder to build the subject structure s ructure. Pleasecco isulany t wiithpyolurHome Owners Association and review your deeaws or d or any restrictionsaawhich maestricty applyibit such 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 illy YOUR PAYING TWICE FOR iMPROYEMEINTTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMEiNT 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/ LesseefContractor as,<gntfor Owner STATE OF FLORIDA_ 1 COUNTY OF I„AI (A P The forgoing instru ent was acknowledge before me this _day of _ _� 25i by if i�� lint - Name of person making tement- Personallylly Known OR Produced identification Type of Identification Produced {Signature -of Notary Public- st- i hotery Public State ar Ronor a + $a L Butterfield Commission No. '�: 1fZ< (6 _ l5Wromm uion GG 302065 -zptres 0211412023 Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF The forgoing instr ent was acknowledged before me this day of 20 by Name of person making stotement_ r Personally Known OR Produced Identification Type of identification Produced f� r t A „' ? 1' f REVIEWS FRONT ZONING SUPERVISOR PLANS COUNTER I REVIEW REVIEW REVIEW DATE RECEIVED DATE of Notary Public- State of aU rvO!ari �uG:-S:ztE I Melissa L BunerFi t No. e3;; .. cr ^ ^;ss Gu q° n �e2r42a23 VEGETATION SEATURTLE MANGROVE REVIEW REVIEW REVIEW