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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONT' ALL APPLICABLE INFO MUST BE COMPLETED Date: 3' 7 Buildin Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 TO BE ACCEPTED Permit Number: % 0/ ko-vo am, r a w 9'J ._ t�J ication 8101 Z _ ddW mmercial Residential 1Z PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED' IMPROVEMENT WtATIONu." Address: L--,. "6� Legal Description: Gl Property Tax ID #: —7-4 P3 r `��Z -- �D �i — ©®G� Lot No. Site Plan Name: I Block No. Project Name: I Setbacks Front Back: Right ISide: Left Side: , DETAILED DESCRIPTION OF,WORK' CONSTRUCTION INFORMAT IONy Additionalwork to be ne orme under this permit - c ec a apply: C�HVAC LJ Gas Tank ❑Gas Piping _ Shutters B Wi ows/Doors Electric Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: % S . Ft. of First Floor: l/ Cost of Construction: $ © Utilities: o Sewer Septic : Building Height: OWNER/LESSEE ,.r. �e n i CONTRACTOR: d:, Name t� I Address:IETSC?4 TZjc-,,� Name: Compan City: State:(. Address: City: r State:L, Zip Code: Fax: Phone No. Zip Code: T24G2Q0 Fax: E-Mail: I Phone No. -'( "1 Zr-- �' —?-� 3 � Fill in fee simple Title Holder on next page (if different I E-Mail: c� hiC ►v«e �� �' L-� from the Owner listed above) I State or County License:& If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION115 LAW INFORMATION:° ` ;A M a_ n• x.,. ' ony^ tl 0> �.: • r" , n ) eMN.0 ', ' a n3 e 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: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worK and installation as InalcateU. 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 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 ..r1, — r ^rriir\O.\ln1ir Alntira of rnmimpnri-i 1prlt_ Col III I ICIIl.111 VVVlnvl IcaWI JII —1 .......... ...... . Signature of ontractor/License Holder Signature of Owner/ Lessee/Contractor s Agent for Ay= STATE OF FLO b:' STATE OF FLO r yLa'✓f� COUNTY OF COUNTY OF •% -, The for oing instr ment was a knowledge efore this day of 20Zdby S rrz The f r oing instrument as ack owledge,Vefore R x{ a A this day of %/% - 20_ by 2 mm 9 �� �-PN�YP d Tm Na a of person making st ement Naga of person making state ent �T Identificat Perso y wn OR Produced IdentificatiPersonally Known OR Produced ' o Identifi tion LF Type of I nti ' a nType Produced Produced 21F (Signature of N t ry Public- State of Florida ) Public- State Florida) (Signature of Not r of Commission No. (Seal). Commission,No. (Seal) REVIEWS FRONT -ZONING SUPERVISOR PLANS GETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REV16 REVIEW REVIEW REVIEW DATE RECEIVED DATE " COMPLETED 3 r7 Rev. 8/2/17