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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA LE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r ,, Date: S Permit Number: /SQU - 0175 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 PR©P®SED IMPR©UEM'ENT LOCATIO Address: E,'�_j1�ic Legal Description: Property Tax ID M �y�� --7(]), 00 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: CONST 11CTI N INFOR IATION: itiona wor to e e orme under this permit—check all appy: HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors Electric ❑ Plumbing OSprinklers Generator Roof Total Sq. Ft of Construction: S Ft.of First Floor: Cost of ConstrOtt -P$� C� O Utilities:Sewer Septic Building Height: f NiER�110 Ea NCr� 1TRA T®�R: RAM ENNIMM Name Address: t 6 'Co ripany'�' ryi:Ci 153 (9U I ur City: ��w. C Stater pAddress. r Zip Code: Fax: "71 �._ AWt 5005 City: State: Phone No. `l 3`7 O 05-155 - Zip Code: Fax: E-Mail: k2tet uL e,0-7+4 1-S (ca 6WVA_kLr�C 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. Sl1.RPLEMENT L.C®'NSTR TI.®N UI I L/�}UU INFC}R(�/IA1I®N# " 2"­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 No ' e of Commencement must be recorded and posted on the jobsite befo e I inspection. If you in d to obtain financing, consult with lender or an attorney before cpKmencing w rk or din Notice of Commencement. s _Signature of Owner Lessee/A nt' ; �� Signature of Contractor/License Holder STATE OF FLO ID STATE OF FLORIDA COUNTY OF l� m A� COUNTY OF The f�oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day Aai,SL 20 IC by this day of 20 by (Name of person acknowledging) (Name of person acknowledging) ign ture of Notary Public- tate of Florida) (Signature of Notary Public-State of Florida) Personally Known R Rr M*d Ident1it91 WMA IN RAM Pe onally Known OR Produced Identification Type of Identification Prod ea". .`��: Notary Public-State of Flo IQ/ of Identification Produced 1 Pad j�p5-1 p� :� _ .•;My Comm.Expires Doe 20, 016 Commission No. �?;`($egTmission#FF 17724 Co mission No. (Seal) Bonded through National Notary i isin. Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS