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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ' �J Permit Number: 13-7-6. 0 C� RECEIVED Building Permit Application Planning and Development services JUN - 92015 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 `B Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PR®P©SED IMPR©VEMENT LOCATION: Address: 0"P C:Z2 ��� r f c Legal Description: _ C 2_�- cLd �� ��� CcC (2. Property Tax ID#: `- 1 t tpb i �� qoo,,'� 0bb "I Lot No. Site Plan Name: (� `/ 1, kA Block No. Project Name: 1G Setbacks Front Back: Right Side: Left Side: DETAILED bES�R�IP'f'14N �F UU®RIK� CONSTRUCTIQN INI=®'R�MAT(©N: Additional wor oto,; e e orme under tis —checkpermit a appy: HVAC : Gas Tank 0Gas Piping Shutters a Windows/Doors MElectric ❑Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S . Ft:of First Floor: Cost of Construction:$ �® •� Utilities:Cn Sewer']Septic Building Height: O�NN'ER/LE-�SSEE: C®NTRACTOR: Name � c� ` (�.� UD�\ - � Name: 0. Address: Company: cSf, flb City: t✓VNGt, O\nA StateAddress: qqD-O Zip Code:Q') Fax: City: State- Phone No. aok Zip Code: G( c gai Fax: /1 E-Mail: Phone No. 1 ^r-) ' rP2?_ Fill in fee simple Title Holder on next page(if different E-Mail:, i n C C— 4�`c tom• �-44'`n4N� . Cowl from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENT�ALCONSTRURCTI® IEN LAW INFORIVIATICENI1 � w f W.111 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 o'n the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recordingAtour Notice of Commencement. atur o 0 ner/ ee/ ent Signat e o r for/Lic Holde STATE OF FLORIDA STATE OF FLORID COUNTY OF �N COUNTY OF P . The forgo' inst ent was acknowledged befor rr �z The forgoing instr ent was acknowledged ling this&day of 20/�by �Dw this day of s 20 t aC r Q 2 "' =;z-0 a' ^ co O 74-p `/ ) _oa~ // ^ r ¢>w � r C k. cr e o. ¢ W (Name of perso acknowledging H (Name of person ac nowledging) ¢vX (Signature of No Public-State of Florida) (Signature of No ry Public-State of Florida •. Personally Known /OR Produced Identification Personally Known OR Produced Ide i is i n Type of Identification Produced - Type of Identification Produced Commission No. (Seal) Commission No. (Seal) 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