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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAPLE INFOI MUSEAE COMPLETED FOR APPLICATION TO BE ACCEPTED L/q I.C. �� f Ct tlttl IY UIIIUCI. �� �� Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce Ft 34982 Phone:(772).462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click here PROPOSED INPROV€MENT LOCATION. . Address: 6MI O etTn er- w; U-e_ Legal Description: 1 i le V 0 Leh-1-4t qb trZe, and W 10-x- vae aw& ad! m S-teSS ` W p r,� Bepiog cam, r .�(- ham, S DO' ( .iv I Property Tax iD#:0� - 601- t?OV3 "000 a Lot No. 1 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ETA-AILED DESCRIPTION OF WORK &anq ocd•1 Cblenu.,L IQaeJ1Ag ctAJ , �gTCit ©a, t® U3, 15 C SQL 1'ne- 00 revel :1,-D" 0S 903. / er A icai, ro r PennrIser brAee_- :CONSTRUCTION-,INFORAaclMATION= : < itiona wor to erlerformea un er t is permit-check all that appy: HVAC ElGas Tank E]Gas Piping _Shutters a Windows/Doors Electric Plumbing Sprinklers E Generator F]Roof Total Sq.Ft of Construction: Sq.Ft.of First Floor: + n Cost of Construction:$ [��0� Utilities:0_Sewer ElSeptic Building Height: OWNER%LESSEE CONTRACTOR. .... ... ..,_r Name !rs' rd, Name: PA �. Address:�'� �l� Company. 'f City:a( e2'2- State: Address: '-� QYYKiT Zip Code: -` f Fax: City: rT- State: Phone No.7-?Z-�Q(0(J-,3SJDq Zip Code: t7 Fax: 17R-tl4ae� E-Mail: Phone No. _1' IO fWG C� Fill in fee simple Title Holder on next page(if different E-Mail: t lilt Y ` from the Owner listed above) Irte or County License: If value of construction is$2500 or more,a RECORDED Notice of Commen66ment 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 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 13001s,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 your Notice of Commencement. - . V3 F riKature of Omer/Agiht/Lissee /?16�ature of Contractor/License Holder ' STATE OF FLORI A STATE OF FLORI COUNTY OFL��� COUNTY OF E� f - The�rjng instrurpent was acknowl d ed before The forgoing instru nt acknowledged before me ec .20E5W1bV thl thi ay of !� day of 20[oty (Name of person acknowledging) (Name of person acknowledging) N rJ-? /2 (Siinature of Notary Q f r, Notary'Pub Stat NP. N R O.VEA, Personally Known 0,�protl* cation Pdrsonally Known 0 ni ic X - Type of Identificatio Type of Identification P r -V 2to # gt 'My46Z o Commission NO.. Commission No. Revised 07/15/2014, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED I