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HomeMy WebLinkAboutBuilding Permit ApplicationI ALL APPLICABLE I FO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� �c Date: Permit Number: /0 O W 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 . Address: 7NO`51 LgK-P,/&rY/�Oya Legal Description; kplzeuJODC% Parit— C/n( �' d Property Tax ID #: /301- 606- 0,92y' 0L — Lot No. Site Plan Name: Block No. Project Name: •�1 Setbacks Front _ �0 Back: J 0 RightSide: t 6 Left Side:© I ns-f eLU Sop 8c-_ Ut o,-N propa L-e tau, + 1 cv-s-es 4-o'ytA ro-I ro e0p�oer %/tee . 'it8a,;'t4l-6AgrworKionenertorM6d under this perms —check a apply: E1HVAC LLB} Gas Tank ❑Gas Piping _ Shutters E]Windows/Doors 0- Electric 0 Plumbing ❑Sprinklers 11 Generator Roof Roof pitch Total Sq. Ft of Construction: S�Ftj of First Floor: Cost of Construction: $ �, Utilities: LJ Sewer 0Septic Building Height: Na City: ra. l/igoe, State: r Zip Code: 3 IS / Fax: Phone No. E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name: Company: 2�_W/lG// Address: 16S D s, City: �Gi d� State:(_ Zip Code: 3 Z22 5� Fax: Phone No. —11 /7 E-Mail: /1') T dr'/p�� as < 60 State or County License: _ 96C-7 if value of construction is $2S00 or more; a RECORDED Notice of Commencement is required. w 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: 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 rep9rding your Notice of Commencement. n a /I n as Agent for Owner STATE OF COUNTY 1 The forgoing in was acknowledged before me this day of . 20 by STATE FLORIDA COUN OF The forgoing instrument was acknowledged before me this day of . 20 by (Name of person acknowledging) 1 (Name of person acknowledging) (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification, Produced Type of Identification Produced Commission No. (Seal) Commission No. (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS