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HomeMy WebLinkAboutBuilding Permit Application~ ALL APPLICABL INFO MU TnEjCOMPLETED FOR APPLICATION TO BE ACCEPTED Date: �j P ermit Number.! 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 tMP$ROVEMENT LOCATION Address: Legal Description: i� 11�� ��>° �(� i-j" �� j� L®i l iQ Z Property Tax ID #: �?W,9 J 61 06 en Q©D T Lot No. Site Plan Name: Block No. Project Name: y Setbacks Front Back: Right Side: Left Side: i F - DETAILED DESCRIPTION, OF WORK. �Yp (G C-e BUJ I I (! rl CONSTRUCTION INFQRMATION . ...3 .. 1 74, Aciditional work to ftG ormun er t is permit- c ea app y: �HVAC as Tank ❑Gas Piping Shutters Windows Do — Q ors Electric El Plumbing []Sprinklers Generator Roof ch Total Sq. Ft of Construction: S . Ft. of First Floor: o6 Cost of Construction: $ `7 ���j 1 UtilitiesSewer Septic Building Height: WNER%LESSEE - CONTRACTOR , IMc111cf ,ryp r` .� �Cl L.C!/�l 1 Name: _ ® vu' 143 CjF -r Address: ( Company: �. City: - Pq)ly Acd State:�L Address: D cL , i Zip Code: Fax: City: State: FL Phone No. %%%- '7`J Q�� Zip Code: .y� 7 Fax: E-Mail: Phone No. - Fill in fee simple Title Holder on next page ( if different E-Mail: Log Y D (, 61uY_),.A from the Owner listed above) State or County License: -��� 00 S%kv:? If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. IIv DESIGNER/ENGINEER: _ Not Applicable MORTGAGE C01 Name:_ � A Name. _ Address: �i Address: City: State:' City: Zip: Phone Zip: FEE SIMPLE TITLE O 7ER: — Not Applicable BONDING Name:_ Name: Address: Address: City: City: Zip: Phone: Zip: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and i 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 tt structure. Please`c nsult with you Home Owners Association andrreview your deed for any restrict that whicf In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform 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 addit accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-r WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your pa improvements to your property. A Notice of Commencement must be recorded and posted before the first inspection. If you intend to obtain financing, consult with lender or an atton comin#ng work or/Acording your Notice of Commencempnt_ Signature of Owner/ Lessee/Contractor as Agent for owner Sig re o ontr ct r/License Holder STATE OF r STATE OF FL COUNTY OF-ORIDA zx-ec(e ICOLINTYOF ORIDAS--7- 4eec The forgoing instrument was acknowledged before me The forgoing instrument was acknowled this 2-5-day of _r1 O (� 20� by this® day of No L) 21 M_p4i2K rc�rq /��� QoC�efZ L r g/9Co� Name of person making statement Name of person making statem Personally Known OR Produced Identification L Personally Known OR Produced Type of Identification Type of Identification Produced �= �1, s��J�fZ� Zq O Produced_ State of Florida ) Commission No. 'Public- State of Flori DEBOPWI RAE y��Off� , Badadllw f&Mbd off.� ]o REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTI COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED .g Rev. 8/2/17 Not Applicable State: dot Applicable stallation as indicated. a subject structure riot or prohibit such may apply. :he work anal use twice for the jobsite before before me by MANGROVE REVIEW