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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED. Date: — Permit Number: wng�°- RECEIVED MAY 2 7 2015 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 �,n PROP(JSBD IMPROUBME T LOCATIQ'N: Address: Legal Description: Property TaxID#: 1�5 "' 1a � ` GOA — (5d0 •—a Lot No. Site Plan Name: Block No. Project Name: `CeJ\(_P, Setbacks Front Back: Right Side: Left Side: DU;,AI!hE:D E-87 R1IP�TI,O:N NF C0f\Q, -6e_ ole S @®N�STR� CTION INFORM/=�TI�N; Additional work toe nertormed under tispermit—check all appy: HVAC Gas Tank E]Gas Piping Shutters I�Windows/Doors Electric ❑_Plumbing Sprinklers Generator Roof C0-, Total Sq. Ft of Construction:y TN�c� Ft. of First Floor: Cost of Construction:$ 7� Utilities: Sewer QSeptic Building Height: OUI/N!ER/LE�SSBE: � �a.NTRACTR:. 4 Name 1 �,\\cir-\ Namer`�=a a.: -�:•,�' �z Address: 9 00 C S 1\toe_ Corrrpa'n�rs. City: _ State:L Address: ' Zi Code: Fax: Cit <.,_° ��=: State: Phone No. J Zip Code: E-Mail: Yle I 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. StJ�PPLEMIENI'AL C©(V'S1'R�U�'Tl®N I.IEtV LAW I'N�F®R�NtAT'LON: 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. L' L ?�G-- , // S _Signature of Owner/Lessee/Agent -Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S LO c COUNTY OF The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me thisa.T day of , 2015 by this day of 20. by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary PublidQState of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Pro ced I i01`��igmoeO` Personally Known OR Produced Identification Type of Identification Produced E� 5�a� Type,of Identification Produced Commission No.. 5 , „ No�a� l o�#�a�N°�a�y Commission No. (Seal) ;� 30� f.-M Gom�r�o°9� Revised 07/15/2014 all- REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS