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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:�� f. Permit Number: s - 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: To Select from dropbox; click arrow at the end of line PRD'P©SED (MPROUEMENl' L©CATION: p Address: X01 lA IL)� Legal Description: V A_� Y%, 9 1,A-1 1 — klV i L O g UK L6-1 l l I Q C on::: -7-S`7 Z:3 •—Kc!1 Property Tax ID#: C) '7, ©— Lot No. Site Plan Name: Block No. Project Name:��Y1�a1 pa(�j�� Ir ro I-e � 'G (�C',��C Setbacks Front_ Back: Right Side: Left Side: X, - - . DETAILED 1PTf(3N p�5n ®Cel E-e 1 eA cit S 10 s LA s e�z-�-�-- �t-rn� ipg A lj a COQ STRLICTION I�Nf©RMATI©N: Additional work to be nertormed un ert is permit—check a appy: HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors Electric 0 Plumbing E]Sprinklers Generator Roof Total Sq. Ft of Construction: SFt.of First Floor: a , Cost of Construction:$ �� Utilities: _Sewer[]Septic Building Height: QeWNER/.EESEE: CONTRACl'®R: Name r9- `zLLC Name: Address: ' z�- '``� D6Y� '-Company.. .... ._ City: �(Q'� L.8 L� !77States FL Address: ['j 9_ ��J•C1Q1&Q IM, --� Zip Code:—500 96 Fax: City: PA ZQ21 Q dR2 (X, State:—LL— Phone No. Zip Code:: Fax E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: "12 kO U< I U,.C;PeC ( from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 111 RISEN 011 1111' 11101 W 1 g SIJPP:LEMENlAL C®NSl'Rit1 I®N LLEN LAU1/ IINFORMATIORI: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: 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 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. s If ignature f Owner/Lessee/Agent Signature • Contractor/License Holder STATE OF FLORI[� -. STATE OF FLORID COUNTY OF COUNTY OF � The fo5going forgoinginstru, wa acknowled ed ore me The fo going inst m�jnt was acknowledged before me this day of 20/ y this�day of� /� 20/�by Name of person acknowledging) Name of person acknowledging) 0"LIQV\_ C__ ! i (Signature of Notary Public-State of Florida) ignature of NotaryPublic-Sta of Florida) Personally Known OR Pro- uc Identification Personally Known OR Produce I e if]] ation Type of Identification Produced (.� . Type of Identification Produced (C Commission No. DAWN MI mmissi No. +ms's_ Notary PUbIIC•St to of F�orida '��� e" �q�yly MIIONE' �', •Ei My Co =. • `;', = Notary PuhNo. Commission # EE 877.571 ' '-'�F Expires °fida ••,,p° Boa:' Commis Mar 22.2017 Revised 07/15/2014 ? - ;7 sion#�EE 877571 .1 �: .• on Through Natio REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE` COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS