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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO M/UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� Date: [ z Permit Number:Im ..M e .. :, 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: To Select from dropbox, click arrow at the end of line P RQ POMQ.:[ MM'0\lE iVI ENT;LOCATI Address: RIIi Ca c7�y�,1 i Legal Description: i-�i, Sys bc�V Property Tax ID #• Site Plan Name: 5tW.W* Project Name: �1 Setbacks, Front Back: I.—LEED- DESC�IE 1 �- Right Side: Left Side: Block No. OR CONSTRUCTION INFO:f�IVIATIONs, : -' jj ��itjional work to b(egej rformed under this permit— cnecK au tnat apply: 1 1 HVAC LJ Gas Tank ❑Gas Piping ElShutters F Windows/Doors Electric 0 Plumbing Sprinklers D Generator M-Roof Total Sq. Ft of Construction: 1 ® So. Ft. of First Floor: Cost of Construction: $ 0 ©Utiliities.Sewer El Septic Building Hecht: r OWNER/LESSEEi r: _ GONTRACi`OR _, Name c CU.5 Name: Address: a Company: C Address: Citv_ State• Zip Code: Fax: City: State• Phone No. Zip Code: 3 Fax: E-Mail: S Phone Ni `7 �- Fill in fee simple Title Holder on next page (if di#ferent C E-Mail: from the Owner listed. above) State or County License: if value of construction is $zsuu or more, a REcunuti, IvotiCe or Lommencemeni 1s reyuu eU. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address' State: City: Zip: Phone: State: City: Zip: Phone: FEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 Silihature of Owner/ Lessee/runt .31gntlLU1 C V7 1.V11L1 WbLV1/ L—..9—,r ,3—' STATE OF FLORIDA / STATE OF FLORIDA �f�T1�1L COUNTY OF COUNTY OF Th f r ing instrum nt was acknowledged before me th11 ay of ' 20 Cjby (signature or c Personally K ow Type of Identific Commission No. Revised 07/1 REVIEWS DATE COMPLETE INITIALS Florida ) Th f ing instrument was acknowledged before me th➢�day of 20 L by (Name of of Florida) OR Produced Identification Personally Wnown k./ OR Produced Identification Produced I Type of Identification Produced Commission No. ROY D FRAMPTON Commission #FF188186 ily Commission Expires Jan. 8, 2019 FRNT ZONG PLANS COUO TER I REVIEW I S REVIEWUPERVISOR I REYIE\N ROY D FRAMPTON Commission #FF188186 My Commission Expires Jan. 8, 2019 VEGETATION I SEA TURTLE I MANGROVE �11EVIEW REVIEW REVIEW