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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll. APPLICABLE INFO MUST BE COIVn"r�ETED FOR APPLICATION TO,I BE ACCEPTEv Date: /� Permit Number: Building P 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 11 Legal Description: SCANNED Residential_ ::Ctnper y cax l4, , 760 - 4,210 — 4700 d 3 Lot No. Site Plan Name: I Block No. Project Name: I Setbacks Front BAF_ Right S If _.4 Left S d �- - � oE,v,,.� I z x i2e,,6cw- s 122, s lv,- x yr' Additional work to be performed under tnis permit- cneck all Mat apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roo itch Motai Sq. Ft of Conu tion: %��� �' I Sq. Ft. of First Floor: ••s f anstT-ctia . $ 1= Utilities: —Sewer —Septic Building Height: ,701QI R IE RSEE: CQNTRA NEW", m 1J Name: Company: ess: / % C Ai /'r/i5 �� 1�li�.PliP State rd Address: pCode: 39 L%JJ Fax: City: State: Phone No. Zip Code: ax: Phone No - ailr r �� Fill in fee simple Titl Holder on next page ( if different E-Mail from the Owner listed above) State or County Li nse IIIf value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNE Name:_ Address:_ City: Zip: NEER: I _ Not App Phon FEE SIMPLE TITLE HOLDER: Name: Address: • City: Zip: Phone:_ State: Not Applicable MORTGAGE COMPANY: Name:-..._ __. Address: - City: Zip: Phone:. BONDING COMPANY: Name: Address: City: Zip: Phone: _ Not Applicable State: Not Applicable OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made 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. I 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 pr©hibit 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 additiops, accessory structures, swimming pools, fences, walls, signs, screen rboms.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.,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 commencing work or recording yqur Notice of Comm'encetnent. 1. . Signature of Offer/ Less STATE OF FLORIDA COUNTY OF The f r oing inst ent this. day of,h /Szf%ractor as Agen or Owner s acknowledge dfore me 20� by (Name/6f person acknowledgi (Signature of Notary Public- S,.at-e of Florida ) Persona �eM cation Type of i BIN 0 BORNE Prod uc . 1,, _t,ommission#GG124118 CommisnnilrH ti¢ ode}°; Bonded ThN Tmy M Signature pf Contractor/License Holder .STATE OF FLORIDA .COUNTY OF The forgoing instrument was acknowledged before me this day of 20_ by (Name of person acknowledging) s (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification Produced Commission No. � , (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW R VIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED �O DATE COMPLETED nev. i/c.v..&+