Loading...
HomeMy WebLinkAboutBuilding Permit ApplicationT _0. 4 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: / ` 0 RECEIVED ra�rr Building Permit Application AUG 0 , 1017 Planning and Development Services Building and Code Regulation Division PERMITTING 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie cow,. FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential—'' PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: &�(� Legal Description: Property Tax ID #: Site Plan Name: Project Name: _. Setbacks Front 1 e, r_9140 «YCJ C/M.� u Z95 -66S bcz� OC) A Back Right Side: 40 4l0 J I 14 [ i 1, N /0/ �• Left Side: �J OQ��'lV Lot No. Block No. Naaitionai worK to De 0HVAC errormea Tank unaer tnis permit- cnecK an ❑Gas Piping apply: aWindows/Doors _Gas _Shutters 11 Electric Plumbing Sprinklers I Generator Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ _ 1 � , S Ft. of First Floor: Utilities:]Sewer 11 Septic Building Height: v CONTRAGTbR ` v.. = Name t� 1 G M.� �( Address\71-._A' a ►n V M y l C Name: i e Company. ,01" City: �Cx \ -AN (_ State-t�A Zip Code: © 'Fax: Address:I � ^- -q P�10 City: u State: %1 Zip Code:,'1�A Fax: '1)9 E-Mail: Phone No. b�� S-S - 1 tq.� E-Mail. is Ek . 'C.Q.m Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License:- .dq LoU o If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. .n DESIGNER/ENGINEER: _ Not Ap 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: 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 vour Notice of Commencement. as Agent for Owner I Signature STATE OWFLO A STATE OF FLORIDA%� COUNTY OF T COUNTY OF A-" [ LI The Ming instr en was acknowledged before me tlay of � (A_ 20 t�bY 1 ng ) (Signature of Notary Public- State of Florida ) Personally Known ✓/ OR Produced Identification Type of Identification Produced Commission No. Revised 07/15/2014 The forgoing instr-ummeent was acknowledged before me thiAn day of \,U\ l44 , 20 A�l by (Name offiArsofi apknowledging ) (Signature of Notary Public- State of Florida ) Personally Known � OR Produced Identification Type of Identification Produced BEV L. HADDAD I Corn sion No. COMMISSION # GG 09363 EXPIRES; July 6, 20 0 it (SealPEV L. HADDAD MY COMMISSION # GG 009363 Public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW EV EWA REVIEW REVIEW REVIEW DATE COMPLETE 1A INITIALS