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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLO FOR APPLICATION TO BE ACCEPTED 1 Date: C1a_AI %S Permit Number: P• sg • 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;WGener`a-or (= PRO.P�®SE® Mr "T VEMENTLOh-CATION } '4, �' � :41 Rs.-z . <.,k Address:AlLCA I ��� S . Legal Description: ( (VVI 1 i Property Tax ID#: V� ^ V© v Lot No.�_ Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 1DE00II1 ERZ D ®ESC4.RIPTdI'®N °UVOfiK '"�` ,� 14 �tr ., n �_1E AA4 r a� ,*.G, r o- i€ trf h ' x r �' "r `' -, E,E�i i+ 4!•d;-n n; CaNSTRl1�Tl,.®N IN ®RNITION 10it . _ itiona wor to e e orme un er t is permit—c ec a appy: HVAC Gas Tank ❑Gas PipingShutters Q Windows/Doors M-Generator O Electric Plumbing Sprinklers Roof Total Sq. Ft of Construction: SFt. of First Floor: Cost of Construction: $ �2�5 a Utilities:CnSewer Septic Building Height: '% r vex.arm imp e �.m �. ®INNER/'LESSEE a � � MCONTRACT®'R ,� t 4 P " Name OVA M606W, Name: Uun Address l cv6 .rUb c- �,Comp.any.; City:.' State: Addre Zip Code: q 11 Fax: City: RW �1 State: Phone No. �L :.Zi Code: Fax: 1 i p L �J E-Mail: Phone NA). Fill in fee simple Title Holder on next page(if different E,Mail: from the Owner listed above) State or County License: D 2 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTFc�vt.TION LIEN LAWINFORMATION 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 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. 0 s _Signature of Owne /Less a/Agent Signatur of Cort "IdKicens older STATE OF FLORIPASTATE OF FLORA �( COUNTY OF G�, COUNTY OF B�/tU1a The f r oing instrument was acknowledged,,before efore me The fo going instr ent was acknowledged before me this�day of 20 bby this _ day of 20 a by i1A (Name of persoi knowledging) (Name of p rson acknowledging) (Signatu of Notary Public-State of FI da) (Signatur o Notary P lic-State o I ida) Personally Known U OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. Commission No. Notary Public State of Florida Notary Public State of Florida Revised 07/1572014 �r< EXP Commission z / 019- zof ��a�f EXpMy Cs ozi27/2ot s 191201 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW;' REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS