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HomeMy WebLinkAboutBuilding Permit Applicationf ALL APPLICABI.lE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //-�� Date: Permit Number: V _ Qs 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 PR(�1�'C)SEDJNI:PRQVEME.NT`LOCATIO;N� ,_ ,w.. Address: 1) d1_1Db JULV16L42 I r 1 e Legal Description:-Gt�K�2 LU�a.P� � C �S t'�C3i� �O ©r)e_ bo n -I t or f 7-U74>94 'Property Tax ID #: 3426- -763 - 0023- CC0 - 2 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front_ Back: Right Side: �— Left Side:_ I A si"a_U nai _L. CQNSTft.UCTlON INFORMATION �o a 1,4 Additional worK to be nertormed under this permit - cleCK III _apply: � as Tank s Piping aWindows/Doors11HVAC Electric 0 Plumbing Sprinklers ElGenerator FIRoof Roof pitch Total Sq. Ft of Construction: - S Ft. of First Floor: Cost of Construction: $ 700 Utilities: Sewer 0 Septic Building Height: OWNER/LESSEE .Name CONTRACTOR Or-SVo a horn0.S Address: 8 9-3 (6 SaMp Z-, e C- Ond--e- City: IDS L - State: F­(_ Name: JP 67�15C_0;r� Company: FL o(LI OP- &,qS 0YP9055,. LLL Address: 4550 S • ��Z Zip Code: Fax: City: 67-Ut-112-7, State: FL - Phone No. QZ9 Zip Code: 3'0 Lf' Fax: E-Mail: Phone No. 77 Z % F1 /12 % E-Mail: qW E? Q-P-f c7a5 • 60 wl Fill in fee simple Title Holder on next page ( if different State or County License: 5_1 S from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. FEE SIMPLE TITLE HOLDER: Name: Address: Citv: Zip: Phone: _ Not Applicable BONDING COMPANY: Name: Address: City: Zip: Phone: Not Applicable 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_yNr Notice of Commencement.. /n_n ,Signature as Agent STATE OF FLORIDA COUNTY F The forgoing instrLffnent was acknowledge ore me this, day of 20 y (Name of person Public- State of Florida ) Personally Known' �_ OR Produced Identification No. ANGELA M HUFF Notary Public - a e of Florida Commission # FF 234730 My Comm. Expires May 27, 2019 WVCIAM4914h national Notary Assn. Signature STATE• F FLORIDA c� A'6"' COON OF \ The forgoing instru ent was acknowledge before me this C1 day of 20 by (Name of person ackn (Signature of Notary I(yblic- State of Florida ) Personally Kn OR Produced Identification NnA+NGEt.A ,V, (Seal) blic - Stage ,, , Commission # FF 21`33473�t Expires May 2 7 Bonded through National hoar 101 YAssn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS