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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED"f �/ Date: S — C� ^ 2 7 Permit Number: / X (' Building Permit Application A06 i 4 2017 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: G 7 © I 4a /a rA B / vd E± I e ►�--� e (T L Y 5 S / Legal Description:iiQ '0 o ec c h — Uck r I q- arJ 3 Property Tax ID #: /.� (� ( // ,� _i- OU (� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back Right Side: Left Side: DPETALLED' DESCRIPTION'OF WORK .. aM a vj- v r CONSTRUGTibk]NFORMATION Additional work to be ertormed under tis permit — check all appFy 1]HVAC Gas Tank Gas Piping 11 _ Shutters Q Windows/Doors Electric ❑ Plumbing []SprinklersI Generator 00 Roof Roof pitch Total Sq. Ft of Construction: l*, oo Q S . Ft. of First Floor: Cost of Construction: $ i / oo Utilities:tSewer 0Septic Building Height: OWNER/L'ESS`EE :` :'.:. CONTRACTOR. Name e , ,v\w�., (� Address: 6 7U/ S cis c. v� G /-arc. 9/-C/ Name: Company: City: � fi Zip Code: �? 1/� �/ Fax: Phone No. ?/,6 State: Address:. City: State: Zip Code: Fax: Phone No. E-Mail: E-Mail:�j �-�N Hdfs: A �� Fill in fee simple Title Holder on next from the Owner listed above) page ( if different State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTALCONSTRUCT.ION:L'IENiLA1N.INFO;RIVIATION ... n 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 we qwr recordinkVour Notice of Commencement. as Agent for 7E OF FLORIDA ,. NTY OF L� a. x0 a The for oing instru nt was acknowledged b fore :, (9 55 ME:m this day of 20 by z = 55 �vcz l- Z3 „ _ n N�� (Name of person acknowledging).co (Signature of No Public- State of Florida ) Personally Known OR Pr aced Iden ification Type of Identification Produced Commission No. (Seal) Revised 07/15/2014 w. VV_ Signature f Co actor STATE OF ORIDA COUNTY OF The forgoing instru er this day of (Name of person ng ) adged before me 20 by (Signatur of Notary Public- State Florida ) Pers ally Known OR Produc d Identification Tv of Identification Produced 01 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS