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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COM'rCETED FOR APPLICATION TO BE ACCEPTEk, Date: 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: Address: Legal Description: Permit Number: v '0 W o 0 Building Permit Application Commercial , Residential < Property Tax ID #: 1 �-1 l � (0()b- ooc(P - 0003 Lot No. Site Plan Name: Block No. Project Name: �.. 4 K.A Setbacks Front Back: Right Side: Left Side: _Mechanical _ Gas Tank —Gas Piping . —Shutters _ Windows/Doors _ Electric Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: a��OK Cost of Construction: $ . ©(�>C) Sq. Ft. of First Floor: Utilities: —Sewer _ Septic Building Height: Name Addres City: ` Stater Zip Code: aR � 1 Fax: Phone No.C-P E-Mail: Fill in fee.simple Title.Holder on next page ( if different from the Owner listed above) Name: Company: City: State: Zip Code: ax: Phone No E-Mail State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. Not Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: 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 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 authorlie 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 thefirst inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording vour Notice of Commencement. of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF as The forgoing instru ent was acknowledged before me this day of 20 �1 by V,4 Do alAD (Name of person ac nowledging ) ' nat re of Notary Public- S to of Florida ) Personally Known OR Produced Identification Type of Identification Produced Commission No. (Seal) Signature'of Contractor/License Holder STATE OF FLORIDA COUNTY OF The forgoing instrument was acknowledged before me this day.of , 20_ by (Name of person acknowledging) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification Produced Commission No. (Seal) �tPLANS REVIEWS FRONT O My : gGlJP19,VI�b0 VEGETATION. 'SEA TURTLE MANGROVE COUNTER1 smrREl lEilVF 1ffl1AEVIEW W! r i REVIEW REVIEW REVIEW DATE fi RECEIVED i DATE COMPLETED Rev. 7/2014