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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /S! SCAOE6 Number: © 0,29 Z al* A BY tU lard St. Lucie County RECEIVED Building Permit Application Planning and Development Services APR 15 2016 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial !Z Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: Legal Description: Property Tax ID # sy,92 .5,0 A - a 69� eln ro Lot No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: t Block No. cnvuncu u11uc1 una Ncium—uie�n an appry: 0HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors Electric 0 Plumbing Sprinklers Generator g Roof Total Sq. Ft of Construction: / / S Ft. of First Floor: Cost of Construction:,$ jai ?/20 Utilities: nSewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: i� / Add ress.,ASO/ Company: rel) City: F7—p/i/'6 t° State: 2�� Zip Code: 3�41 i7 O/ Fax: Phone NAJW o/a3 1/47 ,7-3 Address: Iff) /2 % City: BedeC 3 Zip Code:. Fax: S' PhoneNlo.S� f 5-70� State:_f_z_L / 33 E-Mail:CDC Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: 6//7)a/ is—,a?r S n• Lo State or County License: E7-;t9k7f it value of construction is %Z5UU or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: Zip: Phone: State: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 bjftecorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult//�fbdlth lender or an attorney before g commencing work or recordinvour Notice of Commencement. If STATE OF FLORIDA / STATE OF FLORIDA COUNTY OF JAI (M M� COUNTY OF 1I60e,7—71) The forgoing instruym�nent was acknowledged before me this day of 0-}-iJn 201(o-by Type of MY Revised 07/15/2014 The forgoing instrument was acknowledged before me this 7 day of 6LD �i , 20 j by (Name of person acknowledging ) (Signature of Notary Public- State of Florida ) j0 Persona Type of Notary Public - StatlffiIprida My-C6mtrc Expires Jdn {{ . 018 Commission N FF 121335 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE 1 INITIALS