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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /l Date:r � Permit Number: RE CE_I E Building PernMAyPippli tion Planning and Development Services Building and Code Regulation Division PERMITTING 2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PRORCfSE® IMPR®�VEI,VIEN`T' LOCAT OIU� ' ' Address:F7 >� �a��£r Lcd Z 7e5 C �r��� �ei'c� �� Legal Description- Propert,y T-ax-ID#:—= J 3 12- , 5-0 0 '0 Li 3- O 0 47.7 Lot No. Z ?.Z_ Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ETAILE®�DE�SCR�CPTI®fl7 0•F V1'/®RK ,kms , ��, �� Fence. on _fo "7_AT�,. /0() c, Fe 17 ce_ oel /t/orrX 5• k//•jG % /00 , 0 y' Gk.ex //-Pr/k, c.cctoss ZAe A/o,-7-15.Ae > ::. 1411 M CON�STR'UCTI®N IN'F®RM�TI®Ns Additionalwork to be erformed under tis permit-check all appy: ❑HVAC Gas Tank ❑Gas Piping Shutters Windows/Doors'P g ❑ Electric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: �,�[( � Sq. Ft. of First Floor: Cost of Construction;$�"/59 Utilities Sewer O Septic Building Height: fixs >y rt -Y .. gsra.xa:m .y ' y �, z¢ u• Xu w ..r rk`' 01NNER/LESSEE111-1-11-10-0CONTRACTOR: ; .0 ., ,.,:;"x'.,;5 . �.,: .-Name— c•rP,- Name: , _Address:y,�3// s- E`Xv i�.A Ps C trGlP_ Company: City: dor% r-c_e State:,� Address: �:Zip Code: 3�f�f.5 Fax: City: State: Phone No. c"7y- S Z 7.P_ Zip Code: Fax: E-Mail:2 •c Iren S%Pods Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Sl1PPLEMENTAL C©NSTRUCTION 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 corcling your Notice of Commencement. ignature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLOR - STATE OF FLORIDA COUNTY OF COUNTY OF The fo.r�gging ins rume was acknowledgedre me The forgoing instrument was acknowledged before me thisCx'�Iay of 20 by this day of 20 _by Name of per,acknowledging) (Name of person acknowledging) ignature of Notary Public-State of tiorida) _(Signature of Notary Public-State of Florida) Personally Known is tion Personally Known OR Produced Identification Type of Identificatio Psi WN M11 g# Type of Identification Produced s 0,7►Y?P.ub"C- � State of Florida Commission No. C0m �llbjres;Mar 22 No. (Seal) k ;or �q?.;' " Commission 0 2017 Bonded ihro h . EE -Commission877571 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE CO M P LETE INITIALS