Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE'ACCEPTED Date: �1 Permit Number: V\ nos> s I 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 PRQPOSED 1M ' ROUEMENl`MEN'N: Address: oq Legal Description: �/`r I V- Dr-- t.- ,�(�(_ - C c� Q un �A- l� PropertyTax ID#: 0 0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAlL�ED D`ILK 01DOI`Oi13 OF �J1YO �K: t/te o✓- C L C I `-I S e(!� S_ ki4 @ONSTR�UCTI®N INF®RMATION: it1 a work to e e orme under tispermit-checka appy: FACGas Tkank ❑Gas Piping Shutters Windows/Doors Electric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ Utilities:Sewer F-]Septic Building Height: 011 OE w:E: C®NTRA ©R: Name# A/7 i Name: Address• Y r�r�S'o Company:0✓ e- 11 •�c ,n,� City: �- State:EC Address:q(og sc-✓ �a-Uv�.�+cCT , Z-/L/ Zip Code: Fax: �C / City: S State: Phone No. �2 ` ©67L Zip Code:, Fax: E-Mail: Phone No.7X5 9-- L, C)-""(- Fill in fee simple Title Holder on next page(if different E-Mail:Oy1e<QQ'1/CoV from the Owner listed above) State or County License x�e_kf��1�L/D If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Sl1F'PLEMEN7 L CONSI'R?lJ �I®N LIEN LP►►U1/ INF. RNIATI®N 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 commen.qing work or, coMing your Notice of Commencement. A� s nature of Owner/Lessee/Agent 9fgfrTtuirebf Contractor/License Holder STATE OF FLORIDA - STATE OF FLORID� '11 COUNTY OF COUNTY OF,-- The F,--The forgoing ins nowledgeogfore me The forgoing instrument was acknowledged me / this day of 20 by this day of 6 t 20A by l or�Q Name of person acknowledging) (Name of person acknowledging) (Signature of Not��OR te of Florida) (Signature of Notary Pub -State f Florida) Personally Known' roduced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. (Seal) Commission No. y (Seal) 68 •26 11 1 11R1 PUe� IIIIII �AINN MILO UAWN MILUNis-State of ' q P = ' Y Comm.Ex Revised 07/15/2014 2�• • = NotaryPublic-State of Florida M 2212Q17 o Pires Mar E My Comm.Expires Mar 22,2017;; of F�o;.• 8 Commission#EE 877571 11111111\ :; oP.\ ,.W. a onal Notary Assn. ded Tho REVIEWS FRO N rZi a sn PLANS VEGETATION SEA TURTLE ISR®'E COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS