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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MU))STPE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: l 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)462-1578 Commercial Residential PERMIT APPLICATION FOR: EJeeiO C PROPOSED INP=ROUEMENT L©CATION: ��''�� Address: Legal Description: Property Tax ID#: o Oa,3 - UO o - (4 Lot No. Site Plan Name: Block No. Project Name: Q('g.i, �No6s'l Setbacks Front Back: Right Side: LeftSide: DETAILED DESCRIPTION (JF WORK: �L' Ly1CC. Q.rPnat �V 2 D 30Cne 0V I1 lQ -tv e.0-I'N RQP10i A(A SYIe��c ca�>, In+t 1 4- ale T�Q d �G\, CO IY�bO c.�•o.n�,..� f S 2� �fa CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that appy: _Mechanical _Gas Tank Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ �5 O O c� Utilities: _Sewer —Septic Building Height: OWN ER/LE�S�S'�EE: CONTRACTOR: Name Name. OSS .2�e Address: Lct ' Company�Or\ G C,L' e, City: State:_ Address: S uJ, 41? `( ec�_ Zip Code:_: eS'41 . oZ Fax: City: vOC •�t �e . State: Phone No. �� ��Z Zip Code: 39ci%'2 Fax: E-Mail: Phone No 772- y N- S7.3q ' Fill in fee simple Title Holder on next page(if different E-Mail dn��C,r�a r,21�c ►moi ���Mcti,I,e 0 from the Owner listed above) State or County LicenseCR I3o14�k� - Sr. a�S/S If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENT` I.CONSTR+U�1'I'®N LIEN LAW II P.Mi MATI 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 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 com n 'n work or recording our Notice of Commenceme J Signature of Owner/Lessee/Agent Signature of Con ractor/License Holder STATE OF FLORID STATE OF FLORID V COUNTY OF , `T COUNTY OF The f9_;going insent was acknowledged before me The rgoing ins ment was acknowledged before me this day of 20 t��y this day of 20_�by (Name of person acknowledgi ) (Name of person acknowle in ) l (Signature of Notary Public-Stat)&.of Florida) (Signature of Notary Public-St to of"Florida) Personally Known Personally Known OR r dyrelclantifi5iti n Type of Identifica on�,,�,�,,,,,, DAWN MILONE Type of Ideritific8,11, Produced a`"�`�jv��` -- Notary Public-State of Florlda ,.+.��„,,a,, DAWN MILONE Produced : ^;� -�r'4 NolefV Publlr,-State of Florida =,* a •"__My Comm.Expires Mar 22,2017 (' My Comm.Expires Mar 22,2017 Commission No. �, '�;' Commiss� I E877571 Commission' ;z ac Commission#EE(6(7Ai) onded Througl,Ra�AM Notary Assn. 9,b"� �a, Bonded Through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.