Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: J Permit Number: / �c r r Building Permit ApplicationJUN 2 4 2015 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.®Pv®SE® IN'RROaUEMIENI' LOCATION: Address: Legal Description: C>`-Iz- Property Tax lD#: �L�/ G� 3C� 0238- 000 0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETALLED DEaSCRIPTION �f 1NDR�K: Fa ��� �- }, C®!NSTR+l1CTION 1'NF©R11/fAl'I®N: _ _ e itiona work to be performed under this permit–c ec a ,t at app,y: _Mechanical Gas Tank _,Gas Piping _Shutters Windows/Doors Electric Plumbing _Sprinklers Generator _Roof Total Sq..F.t of Construction: Sq. Ft.of First Floor.:, Cost of Construction:$ 2100 Utilities: -Sewer _Septic Building Height: OUVN=ER/LE�S�-SEE:: -` �C�®�NRAT®R: LC- Name: Address: /. Wne— Company: \" Q C-, City: �cw\ State: Address: 66 W c '-o Zip Code: 333 7i Fax: City: PO4 - CState: Phone No. ,SLI 2�Sai �� Z Zip Code: 3/V15 Fax: E-Mail: Phone No 772— Fill in fee simple Title Holder on next page (if different E-Mail 9 9&&\J� from the Owner listed above) State or County License if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S1JPP'LEMENTA@09,NOTRl1CTl;0N l.l'EN SUV 1' FQRIVIATI` 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: 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'dr 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 aifrespects, 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. Ir Signature of Owner Lessee/Agent ` "= g / __ Signature of Contractor/License Holder : �• r' .� coq:*�= • STATE OF FLORIDAIL STATE OF FLORIDA COUNTY OF o COUNTY OF a m{ The forgoing ins ru t was acknowledged for raeT M The fo��p)ing in r nt was acknowledge Jbe gre mr thi day of 20a by �'�m this vR day of 20� b z Wo= Q : � Z C T' T p 25 =T c a�7T 7m7 (Name of person acknowledging) (Name of person acknowledging) Z-17 \-� \-41— ow h I A� - JA (Signature of otary Public-State of Flo ida) ( nature of N ryP`u61ic-State of Flo5A ) Personally Known OR Produced Identification / Personally K OR Produced Identificatior� Type of Idenicat Type of Identifi io Produced Produced ., Commission No... (Seal) Commission`,No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE - RECEIVED DATE COMPLETED ev. 7/2014