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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n �l r Date: / Permit Number: (, / `(�V7 �. 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: ,�i.'-A�5 PR P©SED INPROUEIffl',!P WfflI LOCATY(,F Address: 44 Legal Description: PropertyTaxlD#: 14110 96- -a'- 014 &OV T Lot No. /5-z Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: MECRIPTION =R4 e- j(Z>C-Icv P CO STRUCTION INFORMATION: Additional work to be pertormed under t E permit-crieck 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: �U Cost of Construction:$ Utilities: —Sewer _Septic Building Height: 0 ' NER/LE,SSEE; CONTRA T®R: Name Name: era✓L Address: P3 - 1 Company: City: �' =.,,.,. it'ic. , Staters Addressf:`, Cd`e S66e' L T Zip Code: C1 Fax: City: ��b State: Phone No. 7b Zip Code: Ag6-9 Fax: E-Mail: Phone No _7, ,Lmeq`" CI'7� S Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SU�PPLEMENI'AL CONST-R�l1CT'fON LIEN LAW INFOR11/IATION; 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. Signature of Owner/Les ee/Agent Signature of Contractor/License Holder STATE COUNTY OF FL� , COUNTYRI STATE OFOFLORIDA The fgrgoing instr en,�was acknowledged-before me The fp�going inst ent Was acknowledge before me this Vr day of u,(? 20LSby this / day of 20 by I(J (Name of person acknowledging) (Name of person acknowledging) (Si ure of Notary Public-State of Florida) of Notary Public-St:to of Florida ) Personally Known OftProduc-1d Fesonally Known OR Pro c d e 'Type of Identfica ion DAWNS � of,ldentJ ti DAWN MILONE Al� 1Produced s�: .Notary Public-State of FI ��� uced ,.�PaY �B{p; Public-State of Florida �.:• M Comm.Expires Mar 22,' y Comm.Expires Mar 22,2017 �o commission #EE 677 71 4_ ,•, e @ My Commission No. t eat "fnission No. :>'::'�'�," Commis )EE 677571 OFFS•,. Bonded Through National Notar oc Bonded Through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.