Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLP INFO UST �BE'COMPLETED FOR APPLICATION TO BE ACCEPTED Date: It l� Permit Number: o 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 PROPOSED IMPROVEMENT LOCATION: Address: 10 IC"�Q. y I y 'c' A-sb.; Legal Description: ��S�� S� ("i�G, _ G� �� �" ®� ti Property Tax ID#: `34 VI — 5_00—.013 1 —©C0 Ll Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: L C�\ e, ®J 5- -Li CONSTRUCTION INFORMATION: Additional work toe e orme un er this permit—check a appy: VAC rl Gas Tank ❑Gas Piping _Shutters Q Windows/Doors DElectric Plumbing OSprinklers 11 Generator E] Roof Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ �4� Utilities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name c�,yao, S Name: P' cis c Address: ko Company: ��^��(-C,.A 4e V\. tcm t� V` � City: V0 C-V �--V�%+"�- State:.C—1 Address: gs q S W V rn A 4 Zip Code: `��� 1� Fax: City: o+— S}Cy(J'p- State: Phone No. �� — �q0—�0 � Zip Code: 3Fax: E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: a+-e,i ccxv,W,c-cc�lre5. C-^h from the Owner listed above) State or County License:9�-O�c CA COE-]4 a\ If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLEHOLDER: _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 striActures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARN O W R:Your failure to Record a Notice of Commencement may result in your paying twice for improv ¢ s to ur property. A Notice of Commence t m rded and posted on the jobsite before h rst i �pection. If you intend to obtain financ' g co t w th I nder or an attorney before Comm I rk or recordin our Notice of Commen e e s _Signature of Owner/Lessee Agent S' ature of Contractor/License Holder STATE OF FLORIDA • STATE OF FLORIDA t COUNTY OF COUNTY OF Th f oing instru nt was acknowledg re me The forgoing inst ument was acknowledged,b me this day of 20 by this�day of 20 by (Name of person acknowledgin ) ( e of person acknow led ng) m i (Signature of Nota Pu lic-State of Florida) / (Si nature o Notary lic-State of Florida) AN Per ons ��Gr�own ANGEO�tapM156ced ntification t// Personally Kno n ...... OR P @Ek1A% cation ti fi Ty p c " aVmrPFWWcL_Wate of Flo, �� Type of Identif t �cjtic�d► c- of Florida '.; ;• Commission# ?• ; Commission#FF 234730 CoMrY�'i+ My Comm.Expires May 27,20 P� My Comm.Expire 2019 I) Commission No one ro Notary As " one hrough Natio Assn. Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS