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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE g-6MPLETED FOR APPLICATION TO BE ACC�FTED Date: Permit Number: l©� ®��V 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: C" , , _^ M„ , _ , A ,nzJ -.,- Address: Legal Description: i�22S7__ �e_� f.,'I oew�J Property Tax ID #: Site Plan NamE Project Name: Setbacks Front V5.5 Back: 7.10 '1 FA Right Side: A O -D LeftSide: 24, v Additional work to be pertormed under this permit - checK all tnat apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters Electric `4lumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: 412-2- Cost of Construction: $ 7 % 1-9On WrI11 0- Sq. Ft. of First Floor: _ Utilities: —Sewer —Septic Address: � City. State:4 Zip ode Fax: Phone No. E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Lot No.'15'3 Address: City: IState: Zip Code:.3 U9.9 Z Fax: L 6o :5 Phone No E-Mail 4- D d r State or County License y if value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: 1 Not Applicable Name: %ALA-5 Address: l LL'5- &4 ft l- City: State: Zip: Phone 3e�� ��SZg- C FEE SIMPLE TITLE HOLDER: of Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby madp to obtain a permit to do the work and installation as indicated. 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 pr perty. A Notice of Commencement must be recorded and posted on the jobsite before the first inspectic . If you intend to obtain financing, consult with lender or an attorney before commencingwork or rec rdin our; Notice of Commencement. + Signature of Owner/ Agen Less ractor Signature of Contractor/License Holder STATE OF FLOW STATE OF FLORIDA //II COUNTY OF -I- (a COUNTY OF f"1 ,/ / 0 The forgoing instrume t was acknowledged before me The f oing instr �rrent,�ras acknowledged before me this /''day of 20a by this day of UU 20/;? by o son acknowledging) (Name o p rson owledging ) (Sign t e of a ic- State of Florida) ature o �p ic- State of Florida ) Personally Know, , �OR Produced Id �ntification — Personally Known ! OR Produced Identification Type�of Identification D1 ype of Identification Produced ,,, Rebetxa �ced .¢�'� om ►ssG aQ`; •.;'i� SHERRIFEHLhIAN ' m 9 202� k j'COMMISSION # FF 101 Commission No. ���b(oDf3'�-l0 a Fxpltes: �riUIY Fission No. �W � EXPIRES: March 14,2( 1f,- 1 BondedThruBudgettlabrySer REVIEWS I COUO TER NT I REVIEW I SUPERVISREVIEWOR I REVIEW PLANS I VEGETATIEV EWON I SEA REVIEW TURTLE EVEWLE I M EVI ANGWVE DATE RECEIVED DATE COMPLETED