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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE I FO MPST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� Date: ��j \ Permit Number: Cs - ®1 1 • 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 PROPOSED"IMPROVEMENT LOC ATIOhI�"_: Address: 5t`�22 LA L+ 1 i/ 'C—A". Legal Description: i . zS PropertyTaxlD#: 6-2R5(E;"0©C9" 1 Lot No. 2S Site Plan Name: Block No. 9_7 Project Name: D IZ.A , I -T !?J,(_,: Setbacks Front Back: Right Side: Left Side: DETAILEDDESCRIPTION.OF WORK .u. , . 5,rvt PA-IZ51— LA-9-c N h(S)MS T© 2 naR %+0e [,)n� CONSTRUCTION:INFORMATION Additional work toe performed a under t is permit-c ec appy: HVAC Gas Tank ❑Gas Piping _Shutters L-/N Windows/Doors 11 Electric rI Plumbing Sprinklers ElGenerator Roof Total Sq.Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ �- Utilities: _Sewer Septic Building Height: 'OSI WR/LESSEt " '"CONTRACTOR.` Name l - - N m 1�C�19('1ii/�'� s�i'H'1. TY�7 ,� ,��y► Address: 2� ,� S� �! [ mpaC�t%t/e-d 2yo`¢i)l!5 r� City: State:iE Address: PO e2 �0 o Zip Code: Fax: City: 1"o wa'- 0 State: Phone No. 51La�-5 `7— 5e)g2- Zip Code: 32 912. Fax: 77)L g2'30-11 E-Mail: Phone No. '32) �� gS Fill in fee simple Title Holder on next page(if different E-Mail: YYl i c co I S�,i 4-h !. -P 1, from the Owner listed above) _;0 lr(::� State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION'LIEN LAW INFORMATION - x' x, 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: 1 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. C..A,n-.c�.J t11 � A ZO s _Signature of Owner/Lessee/Agent nature of Contract /License Holder STATE OF FLORIDA STATE OF FLOR.ID&, COUNTY OF Li,tCj o (� COUNTY OF :3&I0A The fgrg ing instrumet/�^�as acknowledg efore me The forgoing instru nt was acknowled e�fore me this`1� ay of /� 20�by this day of 20�J by vyl (Name o person acknowledging) (Nam f erson acknowledging) (Sigriature of Notary ublic- tate of Florida) (Signature of Notary Public-S e of Florida) Personally Known `� OR Produced entification Personally Known l/ OR Produced Identification Type of Identification Produced Type of Identification Produced SHERI Lr, .�3st. Commission No.EE � � I) CO n No.�����j�a�0 (Seal) -R •'= COMMIBSIC:�+•J ..-. :5L�lti EXPIM J'; ' �i"ss Flatewom rye+.,G.;w�: Sa•• •'= MY COMMlS810N#EE176028 Revised 07/15/2014 EXPIK$June 22.2D18 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATITW moo+ SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS