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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APP Date: MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 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: Address: Jn Legal Description: Property Tax IC Site Plan Name Project Name: Setbacks Front Back: Right Side: Left Side: Additional work to be pertormed under this permit— check all that apply: _Mechanical G ank —Gas Piping _ Shutters — Windows/Doors _ _ Electric � Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ aq C Sq. Ft. of First Floor: _ Utilities: —Sewer —Septic Building Height: Sf h«"; Name Name: Company: Address: i Address: &&LA) j City: Sta Zip Code _,), Fax: Citw o Stat _ Phone No. "� Q Al Lb ( Zip CJe2S9 a Fax: E-Mail: Phone No zi e b E-Mail l tl^' , 1 ol CA6 Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea. SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: llESiGNER/ENGINEER: _ Not Applicable Name: ` MORTGAGE COMPANY: y Not Applicable Name: Address: City: State: Zip: Phone, Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: 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 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 wort: iri 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 RECORDER AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION, W YOU INTEND TO OBTAIN FINANCING, CONSULT NEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENTw" Wi i H YOUR LENDER OR AN ATTOR i Signature of Owner/ Lessee/Contractor as nt for Owner Signature of Contractor/License Holder (FLORIDA STATE OF STATE OF FLORIDA', 1 11U611 e 1 COUNTY ©F ,�tl Gt P COUNTY OF �� , I The forgoing instru ent was acknowledge before me ` 1 The forgoing instr ent was acknowledged before me i this day of � 20 , by this l&day of 1./ 20 by _ic I} Name of person making statement. Name of person making S*Iement_ } Personally Known C-' OR Produced identification Personally Known OR Produced Identification Type of Identification L Type of identification i Produced Produced 1 if t 1 1 N �jj/ �' +f .^{ s'1. t t}lfi \ /lj�•^•J'V/"t %�.'` 4,/ T� i /'ill (Signat rre cf Notary Public- St nature of Notary Public- State of 00'Cii, Notary Public state at Fiona Butterfield j �r -".ion Commission No. '` .11� IJ (S ammrssion GG 302065 - as'+u� `.,a r Pub.c S e ssa L Ou'e i li C mission No. M G �: eal},, T s3 n GG 'i _ _ _� h�oF:t' E eras 0211412023 '}ore. �.�':•�`r.";':2as3 ,,. REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE 1 REVIEW DATE j P,ECEiVED i � I DATE COMPLETED Rev. 2/7/19