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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL AP LIC BLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Da e: 51 Permit Number: Building Permit Application �J Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 y Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ^. PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 5 (� PR`OPOSEDI4VIP,ROUENIENT°.LOCATION & o n Address:,. QJcS� nr je.se.. 6eac,[y 3�f95"7 Legal De.,M Property Tax ID #: Site Plan Name: _ Project INa me: _ Back: Right Side: .3'.S�ooy S nSIE, Left Side: Lot No. Block A--S Cl ert c e Auuiuunai WUIK i.0 Lin cuunueLi unuci Lilo Pciinu—uic�n au apply. QJIWC Gas Tank Gas Piping _Shutters ❑Windows/Doors 11EIllectric Plumbing Sprinklers 11Generator ElRoof Total Sq.- Ft of Construction: 10 W 4$ S Ft. of First Floor: '�3 7C Cost ofionstruction:Sg� ir!i�� Utilities:SewerE]Septic Building Height: y13/LESSEE .,t,r,`a f _� CONTRRC} Off , t --E, t a r x I Name Name Address: Company: City State: Zip Code: _� Fax: Phone No, �� -�%%� �� Address:/ ��✓ IL_ City: /Qi p l Zi Code: '� Phone No L'1C?r�/ fs State: Fax: �� 9 Y�0✓� __ E-Mail Fill in fie simple Title Holder on next page (if different from t ie Owner listed above) L— E-Mai .41ePd) 0 YQ 1)EqN/X State or CDuntyticense: J irvalue bf construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLIE, �VIENTALrCONSTRIICTION.l.1EN,l�l1/ INF©Rlti?tAT10N:`F DESIG ER/ENGINEER: n / Name / Not Applicable MORTGAGE COMPANY: ` Not Applicable Name: /i✓/ Address: Address: City: Zip: Phone: State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: _ Name:I Not Applicable BONDING COMPANY: _Not Name: Al Applicable Address: J'y Address: City: City: Zip: Phone: Zip: Phone: I certify ,that no work or installation has commenced prior to the issuance of a permit. St. LucielCounty makes no representation that is granting a permit will authorize the permit holder to build the subject structure which! 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 TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for ants to your property. A Notice of Commencement must be recorded and posted on the jobsite first inspection. If you intend to obtain financing, consult with lender or an attorney before if! work or recordina vour Notice of Commencement. STATE,OF FLORIDA n�1 COUNTY OF U/(YI._ I The f c Ing instru nt was a knowledged before me this) �; day of�, 20 14 by I (1nAn.PJcx_. (Name(Name of 4owled ing ) of Contractor/License Holder STATE OF FLORIDA COUNTYOF The f going instr nt was cknowledged before me this) day of I P➢ �— . 20_14 by (Name of person adnowledking ) (SignatdI re of Notary Pub is -St a of Florida ) (Signature OiW Personally Known OR Produced Identification Personally Known Type of II.dentificim. Type of Identificai Commission No. MY��OMMISSIONNFF014070 Commission No. S: July 27, 2017 Burled tbru Notary Public Untlunntlan 07/15/2014 Florida ) OR Produced Identification DONZA V # FF 014070 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE I COUNTER REVIEW EVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS