Loading...
HomeMy WebLinkAboutBuilding Permit Application (2) All APPLICABLE INFO M ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �' . Permit Number: 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)4624578 Commercial Residential K PERIVI IT APPLICATION FOR: t Address: "1-' �A © Co. 6 5 �i ce— Legal Description: w(e �d w&� yeC4 Z. Ck uo hcy Zo Property Tax ID#: 0 Lot No. 7 e� Site Plan Name: Block No. , Project Name: � Qs Setbacks Front Back: Right Side: Left Side: . tional work to be performed under this permit—check all tat app y: _Mechanical _Gas Tank _Gas Piping —Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator X Roof Total Sq. Ft of Construction: 22 Sq. Ft.of First Floor: 2 Z l Cost of Construction:$ g 1 100. 0© Utilities: —Sewer —Septic Building Height: Name �© t :.. S tk�-��5. kkit t7o. -1". Name: t (C<4 pe AddreCompany:00p— City. \( , _ State* Address .' Zip Codea. q` f�,ry . ' Fax: IJ �l City : O `' SL Stater ' : Phone No. Zip Code-3 ��.�` Fax: �3 2-`�3 -q3 E-Mail: 0 Phone No Fill in fee simple Title Holder on next page(if different E-Mail ©Pe_Ccpl !��e>0 0f)NcCes e:�M@d-C from the Owner listed above) State or County License 3 b G Z 3 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. la gL 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: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. 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 pians,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. CAN Hx bil Signature of Owner/Agent/Lessee/Contractor Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORID 1 COUNTY OF Com/ `�`��-- COUNTY OF The f oing instrument was acknowledged before me The forgoing instrument was.acknowledAd before me this day of !",201�_by this_�L day of_. 21 by ; of person acknowledging) (Name o person acknowledging) a ure of Notary Public- a of Flo ' ) ure of Notary Public-Sta of Florida) Personally Known OR Produc Produced Identification. Personally Known OR Produced Identification Type of IdentificationType of Identification Produced Produced -DAWN M1 �'� A"8°' Public- t DE`�,jRV ie� Seal)DAWN MILONE ommission No ?�° `�° NotrryCommission No. .o ,�-, rr ; p�j,E10 ritOtiry Public-State of Floritl EN �8 Cofnmissinn IM;EE My.Goenn.EXpire3 IMar 22 iihY1R -°. s-s 33 on#,EE'877571 REVIEWS FRONT #it Th s n. PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW E EVIEW REVIEW REVIEW. REVIEW DATE RECEIVED DATE COMPLETED ev.