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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPLICABLE 1 O MUJ BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: SCANNED 4 Permit Number: 0 1 Is,—=Y BY o St. Lucie County Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34962 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial 1/ Residential PERMIT APPLICATION FOR. To Select from dropbox, click arrow at the end of line III Address: Legal Description: Property Tax ID #: Lfm(;—5-0 t ^ OyInif) ` Lot No. Site Plan Name: r Block No. Project Name OG(_ .Setbacks Front Back: Right Side: LeftSide: -Krk�r-i/� � S/1 c.4 y Gas Tank IS �,446K Sfl,-ftrks. qhD,P Electric 0 Plumbing USpr Total Sq. Ft of Construction: �7r SO O Cost of Construction: $ 7 r OO© • OD Piping L_JShutters lk :rs L 1 Generator S Ft. of First Floor. _ Utilitiesn Sewer 11 Septic .�7 a� Windows/Doors 51<0in�of Building Height: Ism OWfV;ER/LESSEE _ _.,.... CONTRACTC►R a w Name E5 Name: S, Address: Company: o n . City -SQL State: If Address o Zip Code: ^Fax: Q Phone No. �7� o[ �� Q ()(i City: State: Zip Code: 3c{7S Fax: Phone No. E-Mail: FIII in fee simple Title Holder on next page ( if different from the Owner listed, above) E-Mail- G State or County License: If value of construction is $Z500 or more, a RECORDED Notice of Commencement is required. Name: Address: City. State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone:_ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address: City: 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 holderto 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 Signature of Owner/ Lessee/Agents' ]Ignature or Coxra[[oqucense noluer STATE OF FL OUNTYOFSTATE OF FLORIDA � J12 COUNTYOFORIDA h—/;I The. fo ojpg instrument was acknowledged before me / army of S� ' •(f— , 20 aby >6 4fe Gmm Personally Known k7 OR Produced Identification Type of Identification Produced Commission No. l� / 8 (Seal) pQ1W him27.3M The forgoing instrument was acknowledged before me thi 4�� 4f Q . 20 La by (Name of pejson acknowledging) (Signature of 15otary P lic to of Florida) Known Personally OR Produced Identification Type of Identificat(iioo'p Produced Commission No. � (Seal) KIERAN DUANE FRAMPTON W CpA1lAIWM A QQ10 11 REVIEWS SUPERVISOR PLANS V WIR ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE (y INITIALS ,