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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INfO MLITB-ECOMPLETED FOR APPLICATION TO BE ACCEPTED Date: / IcJ7Permit Number: I • Bu"I(ding 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: _Syoy P,i1L/`'lE77� 0,2tr, �•��pi�y�cF. �L 3 y ��� Legal Description: F37*MS-gN17- A�6 .Lar 31 /r oR L- 9 Property Tax ID #: 3 D 7 — 000 a — b O O® Lot No. � Site Plan Name: Block No. Project Name: Setbacks Front Back: f-24 rRight Side: 30c" LeftSide: 'l L DETAILED DESCRIPTION OF WORK: 6' `7a ©, SF CONSTRUCTION INFORMATION: Haamonai worK to oe errormea unaer tnis permit- ci [1HVAC Gas Tank ❑Gas Piping Electric 0 Plumbing Sprinklers Total Sq. Ft of Construction: /02 D Cost of Construction: $ 42Q Shutters Q Windows/Doors Generator g Roof So. Ft. of First Floor: _ Utilities: 0 Sewer Septic Roof pitch Building Height: /Q `* OWNERAESSEE: CONTRACTOR: NameaA%Z)�P+ Name: Address:_ -qd l ?AC/7t7 77P Company: >'t-- Sid City: �0%Z I ,P/�� State: �� Address: % Z( i yl0 Zip Code: 'ZU Fax: City: n/E%1C� State: �L Phone No. -%7a-- / & 7—-D Zip Code:.3' qqO — Fax: 69-1 S�u-rt A c� Phone N r - "'00 Fill in fee simple Title Holder on next page (if different / E-Mail: A 5f' �IgrS�C from the Owner listed above) State or County License: it value of constructior)15 5Z500 or more, a RECORDED Notice of Commencement is required. 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: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: 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 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, consult with lender or an attorney before commencing work or recording your Notice of Commencement. Sigh4t6re of Owner/ essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA ��GI�— STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrum was acknowledg efore me this '1day of 20Q by The forgoing instrument was acknowledged before me this day of . 20_ by Name of person making statement / Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatkom 1 Type of Identification D� 1) � fv-\ Produced F- `4ar Produced (Signature ofi to ida) (Signature of Notary Public- State of Florida ) [� { M HUF ¢Seal * �: Notary Commis 1Vtate Commission No. (Seal) of`rlor(�a Commission # FF 234730 My Comm. Expires �nnna May 27 2019 lVdilonal NotaryAsst. REVIEWS FRONT ZON ' G'SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE JI F�17 COMPLETED I Rev.8/2/17 1 , /