Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEu Date: I I Permit Number: Building Permit Application P�a�1-4%tAG Planning and Development Services uc►e Coves L Building and Code Regulation Division St. 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772).462-1553 Fax: (772) 4624578 Commercial Residential PERMIT APPLICATION FOR: A®%��' ��� �'%� LD —4/70 aq•S7 Address: /6-s- Cj`�Q Legal Description: W I(?- a-F 2(0 :DNA W ' 12 o�-" L o i 2`7 -� Property Tax ID #:4 O �- r0 k KO (n�)o h Lot No.,)4 Site Plan Name: Block No�zc> Project Name: Setbacks Front 100 Back: S Right Side: 10 Left Side: 12-0 " - rzq ve pertormed under this permit- check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ �dy Sprinklers _ Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: C� %� ��/ If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUP LEM�NT LC(JNTRUCTI©N LIEN LAW INFORMATION: DESIGNER/ENG1 Name: EER: _ Not Applicable MORTGAGE C Name: Address: City: Zip: MPANY: _ Not Applicable Address: I City: State: I Zip: P h oh e I I rl State: hone: FEE SIMPLE TITLE Name: Address: City: OLDER: _ Not Applicable BONDING CO Name: Address: PANY: _Not Applicable IG- I I City: Zip: P one: I I Zip: hone: OWNER/ CONTRACTOR AFFIDVIT: Application is he I certify that no work or installation has commenced prior )y made to obtain a permit to do the work and installation as indicated. 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 Not!( improvements to your property. A Notice of Comm before the first 'nspection. If you intend to obtain.fi commencir Work or cor ing your Notice of Com of Commencement may result in your paying twice for icement must be recorded and posted on the jobsite 3ncing, consult with lend attorney before encement. /I ,� I Signature of Owner/ Le ee/Contractor as Agent for Owner Sig ature of Contractor/Veense Holder STATE OF COUNTY F ORIDA.���, -� STATE OF FLORIDA S1 Q COUNTY OF The for oing instru ent was cknowledged before me this ' day of / C'� 20) by The fo��r �oing instr ment wa acknowledged before me this / day of L)tQ �'� e� . 20�by om2S � J ei 0 0 hs Name of person making statement. Name of person making statement. Personally Known OR Produced Identification L I Personally Known OR Produced Identification t/ Type of Identification I%'$ L' c eJ-6-R-- Type of Identification Produced Produced ZJC -e'r- V h , (Signature o otary Public- State of Notary Public- S a e of`FfB� a 0=goY0340 Commission No. HASSNASANABRIA :°�"` `� MISSION #FF904036 1 ( 2019 ((Signature Commission No. ..�ASSNASANABRIA My SION #FF904036 EXPIRES: JUL 28, Insurance JUL 28, 2019 OF Bonded through INN Bonded through let State tst State Insurance REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE 1 I RECEIVED DATE COMPLETED I ev. I