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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: / Address -7205­ 519W7-4N.4 /nn 14!5j Legal Description: ������ �, 4/Q4� 1/`'1 ,71- / SIX30 z Property Tax ID #: i13 D O 9©� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 9/17/l�� If - CONSTRUCTION INFORMATION: 114 f T!�'L- itiona work to e nertormed under this permit - check all apply: EjHVAC 0Gas Tank ❑Gas Piping _ Shutters a Windows/Doors ❑_ Electric ❑_ Plumbing Sprinklers ElGenerator Roof Roof pitch Total Sq. Ft of Construction: 'g&'06 S . Ft. of First Floor: Cost of Construction: $ O©O , 4*0 Utilities:Cn Sewer E]Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name °cr''v Name: /°��5 Cacc. i r✓5 Company:COui�/S Address: "-7005_cS UI Address: /00 6001 Z ZAN` 7 ' City: �—p/� Y i /'G e- State: ):=I- Zip Code: 34 "75-7 Fax: City: "r'o' ".T PA S State: FL Phone No. `7 % -L Zip Code: SelI ? 9 _ Fax: E-Mail: — Phone No. 7?Z 1-0 / /3.'S'Z Fill in fee simple Title Holder on next page (if different E-Mail: State or County License: CU D5110 t 1 from the Owner listed above) If value of constrUCtion is 575OU or more, a KtLUKUtU ijouce OT L.Ommencerncna Ib Icyuncu. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: 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 t �aspection ntend to obtain financing, consult with lender or an attorney before co encing rk/br cording vr Notice of Commencement. �--� Owner/Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF The forgoing instr ent as acknowledged before me this day of 20 A.by n of person STATE OF FLORIDA COUNTY OF The forgoing inst ment was acknowledged before me this J day of 20 a by (Name of person (Signature of Notary Public -State of Florida ) (Signature of Notary Public-tae of Florida ) Personally Known OR Produced Identification Personally Known OR Produc d Identification Type of Identification Produced J'� , (�� Type of Identi a iq ;P_rWue-ed,,_ 4n.. E)( �pY�� IAR �NCom(�Hy•{!' Y�,(pY Yyoic, , � �`5,•P,,''JS( �N, oSn . �{ N��ail mission No, Commission > Comm. 156 `7 <A2EU S. NIELSEfss�onExpires cr JUnn 71> ' = My Commission Expires Revised 07/15/20 _111 °° June 12, 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS