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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �Ol �i�Qc- Permit Number: N �n �� �I SCABNNED • -- _ - _ -- - - --- - -- -- -- - -- -- ---St:-Lucie County - - -- -"- 0 mow 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 Residential PERMIT APPLICATION FOR: P(6P©t3Rt ilt tt }CAEfs u ' Address: , Legal Description: % l [J DR Property Tax ID #: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: d,i-,. � }J• T��l: i•,�?n'w[� sf�>" `=' �eKc£.i+t�4 ��g}�h �i:�3n��y}�{+.�.`^"_ C Y..S��5 .0 e t �y Ff tit/L'i ilAG0k'-3?�Ti..Eit< inona Wor to a per unne un ert is PU1111IL—ClIeCK all mal app y. _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: I kQ0 Sq. Ft. of First Floor: Cost of Construction: $ (2 i'c)(0 Utilities: — Sewer _ Septic Building Height: XE .Y ar.xS.���Y�SL'arR.i'. �Y+'i Vi S#`'�1S�y yc..0 i✓t �.F2f �.�{'}'=�Sn£ e _ ` Name Name:—Diaw` i Address: Company: e i City: State: Address: I j Zip Code: Fax: City: State: Phone No. T%� 1=_ i Zip Code: Fax: I E-Mail: Phone No Fill in fee simple Title Holder on next page ( if different I E-Mail re \� ^ from the Owner listed above) ate or County License 0 If value of constructinn is 7500r REC o more, a ORDED Notice of Commencement is required. i DESIGNER/ENGINEER: / NotA Applicable _ PP MORTGAGE COMPANY: _ Not Applicable Name: i Name: Address: Address: City: - State: City: State: I Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: i Name: j Address: Address: City. -- — -- — — -- - - City: Zip Phone: j Zip: Phone: i 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. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure is 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 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 commencing work or recording our Notice of Commencement. I 1 _NgnkJrLrbf Owner a ee/Contr or as - wrier Sig 2 of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OFF The fQr�oing instrument was acknowledge before me The forgoing instrum t was acknowled ed before me I V' thisoCd day of _� 20� by thipZa day of 20� by (Name o person acknowledging) (Name of person acknowledging) I QViid'�Tc1. \ XY`(8.J-T�C".1t� h e v.� I �1.J\[JR�Q11141.1V (Signature of Notary Public- State of Florida)T— ` A(atuVe of Notary Public- 5 to of Florida ) I Personally Known OR Produced Identification I Personally Known OR Produced Identification Type of Identification Type of Identification i Produced Produced I I Commission No. (Seal) Commission No. (Seal) f I I - REVIEWS i FRONT I I ZONING SUPERVISOR i PLANS I VEGETATION I SEATURTLE I I MANGROVE COUNTER I REVIEW REVIEW REVIEW REVIEW I REVIEW i j REVIEW DATE RECEIVED j ; , DATE COMPLETED ev. 4