Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: °� I 1 • -�(.P� • Building Permit Application R Planning and Development Services Building and Code Regulation Division NOY 212 2017 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: Lr. 7 � I � Legal Description:_©_f 4t s GE iq -e5ti9,E7:5 eSt*D t7 I Property Tax ID#:_c, �-� — 2 •c��� (�c�,G. Lot No. Site Plan Name: t�oyP L bF4- i l Block No.� Project Name: C g l ca.!y e Setbacks Front Back: Right Side: Left Side: i DETAILED DESCRIPTION OF WORK: I� CONSTRUCTION INF=ORMATION. . Additional work to e e orme under this permit—check a apply: �HVAC E]GasTank _ ❑Gas Piping _Shutters Q Windows/Doors Electric 0 Plumbing ❑Sprinklers 11 Generator' Ysloof Roof pitch I Total Sq. Ft of Construction: Z0, C)0 S . Ft.of First Floor: Cost of Construction:$ _t��L,�'/C�. s,� Utilities:Sewer Septic Building Height: I OWNER/LESSEE CONTRACTORI: Name C17-1/GD� ?�/-t/z26 -/oLe 5 Name: W i S 1 _7£,9- Address: //y'ZU i�cj 44" /° Company: S�i� %�'�I p Y� City: State:d�L Address: 06/ ti6t/ 6 W�r1 i Zip Code:_3�t92. Fax: City: P 1�/ Stater Phone No. _-5-iW _-16 ' 75 9/7 Zip Code: 3 Y�­9f6 !Fax: E-Mail: Phone No. Z-3 • 6PZA:!�, Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: I If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. . � 1 I SUPPLEMENTAL CONSTRUCTION LIEN.LAW INFORMATION DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: I FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: i Not Applicable Name: Name: Address: Address: i City: City: Zip: Phone: Zip: Phone: I � OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit;to do the woik and installation as indicated. 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, cons It with lender or an attorney before commencing work or recording our Notice of Commencement I � I i I Signature of Owner essee n ractor as Agent for Owner Sig a , re of Co a /License Holder STATE OF FLORIDA _ STATE OF FLORIDA COUNTY OF '� .�u« COUNTY OF ,.,_)c o' The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 15- day of ,A/d V 200 by this day ofQ i1 I 20/7 by I Name of of p orse orse n making statement Name of person making statement Personally Known_V OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Pub Q ite tlfat�Wld Pierre-LOUiS (Signature of Notary ublic-Statg of F[orid anueiie pierce-Louis -o�' ,,. `�IPP�'Pu$<�% C # FF964172 _a ; _ mist FF964172 b _ i 4 a Commission No. _ commis n Commission No. _� �`��" CO �a��40n 2 ,242 Expires N 24,202Q _ Ey' ices'.,enru2ry Bonded thru Aaron Notary Bonded thru Aaron Notary OFF����� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 I I