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HomeMy WebLinkAboutBuilding Permit ApplicationNOT ALL APPLICAB E INF UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1(1_7 Permit Number:y " 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: UA41 1. hXMQ I (7 .06 A-+7 .©Vp nOtI , W 6A I - al Description: 61 �Lo h I.yxvl = I _r 1 Property Tax ID #: 1 . I (onc) Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: .. Right Side: Left Side: DETAILED DESCRIPTION OF WORK: vkr\d b-h I,YA � vq�6_,�l ckAJ mti Y1+- bi V-z CA- -ro �lo o `:CONSTRUCTION INFORMATION: Additionalworl(totignprrormed under this permit —check all apply-. 0HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors Electric Plumbing U Sprinklers FjGenerator Roof Roof pitch Total Sq. Ft of Construction: 6 Sci. Ft. of First Floor: 1 Cost of Construction: $ b Utilities: Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: _ Name l im i E&A 4*h)Name:_0Sik1I D Address:100 h w w Company: I —IAA / f &-no r(3a* 1(\a . City: 011kt-f C n O ch'i 'e State:IL(,, Address: , I Q U 13 S �1A_G�. `b V�i Zip Code: Fax: State EL Phone No. f Q z — 'Z a�-- v Zip Code: 1 Z Fax: E-Mail: Phone No. Fill in fee simple Title Holder on next page ( if different E-Mail: from the Owner listed above) State or County License: C, L L 13,-i 3 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. A SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 thework 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 ace,essory uses to another non_residential use WARNING TO OWNER: Your failure to Record a Notice of Commencem nt may result i our paying twice for improve ents to your pperty. A Notice of Commencement must recorded d osted on the jobsite before thil inspecfl. If you intend to obtain fin ' g, consult ith iende , or n attorney before Icommencilhe work Wretordingvour Notice of mencement. ' i Signature of Owner/Lessee/Contractor as Agent for Owner •Signature STATE OF FLORIDA COUNTY OF The frogoing instrument was acknowledged before -me this day of 20 Llby DS 1e of person Personally Known / OR Produced Identification Type of Identification Produced Commission No. Revised 07/15/2014 MARLINA EXPIRES June 13, 2021 STATE OF FLORIDA COUNTY OF The forgoing instr4knent was acknowledged before me this _4day of 20 _ by (Name of person acknowledging) (Signature of Ndtary Public- StSfe of Florida) Personally,Known / OR/Produced Identification Type of Identification Produced Commission No. MARLINA GODINEZ EXPIRES June 13, 2021 REVIEWS FRONT ZONING SUPERVISOR .PLANS VEGETATION, SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE b INITIALS