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HomeMy WebLinkAboutBuilding Permit Application All APPLICAB IJFO MUS BE CO LETED FOR APPLICATION TO BE ACCEPTED . Date: 2L 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: PR(JR SED INPROUEMENT L�CATI� : Address: '5"Ya ' �R_ l t' P'r�rG`�. F1 ���y �0 Lot I LI Legal Description: Property Tax ID#: r �� �I Lot No. Site Plan Name: i NB��CI'e.S �Cl�',\t_ 01 1 ', TI-A)c a Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET ILED1ISGRIPTIQ' OF WORK: -aEg2 CONSTRUCTI(JN UNFORMATION: itiona wor to ne pe orme un er t is permit—cngcR 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.Construct o.n: $ Z-300 Utilities: _Sewer Septic Building Height: OWNER/_ LE�S�SEE: Gf!?NuTRAC'�TO,R: F,: Name Na m"e: N\'� X'CL Address: I C~ any:, 1 City: V1Q4 State d"ess' 99 fh r' Zip Code: Fax: City: State: Phone No. _4�� Zip Code: Fax: E-Mail: Phone No �S(o l ` SZG -'-1191-1 Fill in fee simple Title Holder on next page (if different E-Mail �1� ' �1�sN 1231 YYI(�i� OS3M from the Owner listed above) State or County License____C If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SU'hPLEI\/IENTA�C®NSl'Rl1'Cl"I'ON LIgEN LAW I�N=F®RIUI,�TION: 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 commencing work or recording our Notice of Commencement. Si na ure of Owner/ ssee/Agent Sig\ria ure of Cot ctor/Licen Hold STATE OF FLORIDA STATE OF FLORIDA . COUNTY OF COUNTY OF u The for + g insUumewas acknowledged before me The for oing instru e t was acknowledged efore me this y of 20 by this qday of J 201A by �_1111M (Name of pers ck owledging) (Name of person ac le ging) (Signature of Notary Public-State of Florid �e�� i�►i�j� (Signature of Notary Public- ate of Florite ONIC4 Personally Known V OR Produc�Ide+ � /��i����i Personally Known 1/ OR Produc Olde ��$�C�R�,'...��:� Type of Identification ;�; S0 �?�c� o s Type of Identification ao, Produced ��,: : Produced =z: ire #FF ® y• w Commission No. © �O 9 •aab) ? *e Commission No. thN Tr ��• u1�1�1\\� 1lft4114 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.