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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J Date: Permit Number: ., RECEIVE® Building Permit Application Planning and Development Services JUN 2 2 20 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 P,;RO-F�OSED IMPR®�VEMENT L®CA,(7N Address: 5C203 ?GlPO eff lam' cir Fof-- 1eice Legal Description:4WHC lOr,4 PLY S _5Z C2 — r h!1 Sc Ij ~ Lo 4- ) I C 6-;'6 � 1 //zS � o�- 3g13�-z3i+-7 3H�9-� �2 3'0Z 7-L? , Property Tax ID#:007 11 Z— o b— o c,>1 Z` O oo--3 Lot No. Site Plan Name: Block No. Project Name: W HiCcft 0"n C Setbacks Front Back: Right Side: Left Side: D:EA,ILED�®E�SCR�IIPTI®, O'F ronor -'�nS L.L._ Additional work to be' a orme -'un ert is permit-check all app,y: " HVAC Gas Tank Gas Piping Shutters FRoof indows/Doors Electric ❑ PlumbingSprinklers Generator Total Sq.Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$�/Z©rte Utilities: Sewer Septic' Building Height D1'l1/ ' ER/LE�SS' E: Y WOO � Name"®_ �®� Name: e�� �G�T`') r'5( Address: *5Ca 03 JAG f rn at?t's C'I` Company: 97c,S+ ( 94- �ae?S-kLj(I/y,1 S _ C City: �� t�l ef-C State:�� Address: Zip Code:A3��1/J�/ Fax: City: i/A���raJ(�e State:EL Phone No, w---)D-2-99C-1•-zz4(1 Zip Code: 3zGI0Fax: '�Z�G���775 E-Mail: Phone No. gI- Z Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: <5 - c 6c IZ� If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. S` P LE'°(1/IENTAL IM;®N�LI'EIV Olt 1111/ IIVFOR I �"I®N' 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 ur paying twice for improvements to your property.A Notice of Commencement must be recorded 'sted on the jobsite before the firs spe ' . If you intend to obtain financing, consult w' lend an attorney before commencin or r cordin our No ' mencement. N�O _Si na re o wrier enz a Sig6a re of Co rac or License Holder N nl a STA E OF FLORIDA m V5N STATE OF FLORIDA LL� COUNTY OF COUNTY OF 4 LU n The f going instr nt was acknowledge befor m m The forgoing instr ent was acknowledged before � w Z this day of 20 by thi �day of y v1 a t td;•,, 20 b � ¢oX >-w m (Name of person acknowledging) (Name of person acknowledging) ;€ "CPqF,e. 4 a f (Signature of of ry Public-State of rTorida) V (Signature o Not Public-State of Forida) Personally Known O ff74uced Identification 11� Personally Known ro ced Identification / Type of Identification Produced Type of Identification Produc d ` Commission No. (Seal) Commission No. T7 (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS