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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:-5 Permit Number:big to _'- 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 S(�� PROPOSED IMPROVEMENT. LOCATION: Address: ZA©( 0 �/ �✓ �- rS. 3 " Legal Description: S z Property Tax ID#: ec»IT— ,, ���-- '� Lot No. Site Plan Name: i L ►�,.L, M , R kp A '_.ems- -rI2 Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF`WORK: o ECONSTRUCTI N INFORMATION: Additional work toa nertormed under this permit—check.a appy: HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors Electric 0 Plumbing Sprinklers 5iiGenerator Roof Total Sq. Ft of Construction:__-zz Sq. Ft. of First Floor: Cost of Construction:$ %_9e7 Utilities: 0Sewer El Septic Building Height: OWNER/LESSEE: CONTRACTOR: Al Name �. Name:_ 61, Address: � ���cdv� Company: e62 � City: wp D�'YState: Address: Zip Code: 3 Fax: City: State: R, Phone No. Zip Code: 3`��c+ Fax: 0 to E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: r5 4-y-aw, c (Jai. ks r��- c avh from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN 'LAW INFORMATION: 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. �i s _Signature of Owner/Lessee/Agent Sign atdicontractor/License Holder STATE OF FLORI STATE OF ORID COUNTY OF COUNTY OF ti` ���`�"'� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this CC; day of 20 15 by this G day of rO 20 (5 by f (blame of per o acknowledging) (Name of per o acknowledging) (Signature of Notary Public-State o rida (Signature of Notary Public-State of Ida) Cersona ly Known OR Produ ed Identification ersonally Known / OR Produc Identification Ty o_Wentific- n Produced on Produced Commission No. Commission No. (Seal) "$ DEBBIE B.SABIN .. H: EXPIRES:May 30 2017 stgti _ _MY GQMMISSION#FF 004072 Revised 07/15/2014 �$ Bonded ThruNotary PubllcUnderwriters '" EXPIRES•May�30.2017 m p, 'Bonded Thru Notary Public Underwriters ; . °f F� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE'' MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW., REVIEW DATE COMPLETE INITIALS