Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ' I ! I II ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEP'fED'� Date: , � � Permit 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 ReSi&ntla�� I iI PERMIT APPLICATION FOR: To Select from dropbox, click arrow atiithe end of line PROPOSED lM 06VE.MENT LOCATION,,. ; Address: 9 r`I?w.S � Ell P1',e7i"c ,e ;I— ,Legal Description: . i`G i n e-S I Property Tax ID#: l ' Q t •0 ! ! I Lot Ncjt-�__ Site Plan Name: 0 = �) I Block No, Project Name: (A T �� I Setbacks Front Back: Right Side: Left Sider DETAILED DESCRIPTION OF WORK: r �CGY�NSTRUCTI�N INFORWI"ON 11 itiona wor to (e' e orme un ert ispermit—c—check k ply: HVAC LJ Gas Tank [:]Gas Piping _Shutters i Q Windows/Doors Electric 0 Plumbing Sprinklers Generator I Roof Roof pitch ! Total Sq.Ft of Construction: Sq_Ft.of First Flooc I:° . I .ei Cost of Construction:$ 1 ,1 ty Utilities: Sewer Septic Building Height: OWNERf LESSEE CONTRATC3R: Name ,G -e- Name: 16 6-m aA`I I--5_5. f. Address:.5 ` '� Company: Me city:ro r`— P i'e--Yc-e-_ State: Address:.a I©r0 Zip Code: 15� Fax: City: rt-ff u,P�l `'�e- !I State: )55�L�C� Phone No.212 I LA00 -A71,415, Zip Code:.3 e.S1 ! Fa)6q 2` .Y E-Mail:C�e� t,1-2-2. 120 M Phone No. ?'' `3, Fill in fee simple Title Holder on next page(if different E-Mail: f lE17�� a� i' ! P!'� rllGAWIdej � I!from the Owner listed above) State or County�icense4"� If value of construction is$2500 or more,a RECORDED Notice of Commencement is required:.! i ' j i SUFFLEM;ENTAL CONSTRUCTlO[ iL(EN'LAW ►NORNiATCON DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: I I City: State: City: I State: Zip: Phone Zip: Phone: I �I • • FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY,. r Not Applicable Name: Name: Address: Address: .I City: City: it Zip: Phone: Zip: Phone: iI QWNER/CONTRACTOR AFFIDViT:Application is hereby made to obtain a permit to do the work and installation as indicated. t 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 mayrestrict 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 cornmencing work or recording our Notice of Commencement. V ��V� 1 Uu lY '�" 1 n Signature of Owner/Lessee/Contractor as Agent for Owner Signature of ntractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF slk--Ilu� COUNTY OF . The forgoing linstrurpent was acknowledged before me The forgoing innsstrilment was acknowledged before me this t�day of 2011 by this�day }V�� _r T Y Name of Ittrson making statement Namec iyrson making statement Personally Known OR Produced Identification Personally Known .0 R Produced Identification Type of Identification Type of Identification i Produced Produced I dSiatu a�Notaryftblic- a ofFlorida) (Siignat a of Notary Pubilc-'State Florida) Commission No. --(Seal).,-- Commission No. I � ?aeFi � i `,��Y eve LASHAHNA iNGRAM �,�Y p�e,, L 3 NA iNGRAM ,�� {,,, a"��`�. Notary Public-State of Florida Notary Public State of Florida I ±e Via¢Dec 20 201 a °'-My Comm.Exoires Dec 20 2018 mmi sion#FF 177249 ¢°;� Commiss on#FF 177249 REVIEWS FRO,T-:dos 4 'N thro g Ue$fiR�fiSf�Rs n. ;PLANS VEGETATI�C?f '''r°��� A 1tt�RTLEroug 111�A�I�.V} n. Co REVIEW- REVIEW REVIEW' REVlE1tV .� %REVEEW-, .: DATE j RECEIVED DATE COMPLETED Rev.8/2/17 ii 1 i a I I