Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u d h Date: -7 Permit Number: RECEIVED JUL 312015 a• 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 PERMITAPPLICATION FOR: p To Select from dro box, click arrow at the end of line Address: 10-75- t Soo-rH ©Q-w Qngs� .9-10 �- Legal Description: Property Tax ID#: '- 1/-- 003-L Lot No. ,3--ia Site Plan-Name: �J Block No. Project Name: is Setbacks Front Back: Right Side: Left Side: ,g dd �127 T z " C4-1 CI u 1 ,— P i F /UrE_ 077/1-47,Y' 00 .717 C i/O/J, Pit! i- Additional work to tipnertormea under tispermit-check all that appy: HVAC Gas Tank Gas Piping Shutters Q Windows/DoorsRi< _Electric Q Plumbing Sprinklers Generator Roof Total Sq.Ft of Construction: S . Ft.of First Floor: �. Cost of Construction:$ 37Y00- 0o utilities: Sewer F]Septic Building Height: Name f/044/-,P T 1 iHGE0d1 Name: F�1/J� �E✓� i�lr �/� Address:26Z6 /�r / iY'l��� � 3�® Company: City: #IC46-0 State:-TL Address: 5La N�J f117 ��7V_ AQ914C Zip Code: 6 66/ 41 Fax: City:.& v �' [UC1 L State:o-c-L I Phone No.765---7ZO ~1Z 312-3® '1524 Zip Code: J Fax: -77Z-,; /() 7y7 E-Mail: r SOY �� Co PhoneNo- Z' �I r Fill in fee simple Title Holder on next page(if different E-Mail: �.�L } County A�' /30 03 `l/..S—' from the Owner listed above State or Coun License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 1= ------------------_...--------- DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: � Not Applicable Name: Name: Address: Address: City: State: City: State: I> Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 thepermit 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 i? 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. s _Signature of Owner/Lessee/Agent Signature of Contractor/License Holar STATE OF FLORA ASTATE OF FLORI q COUNTY OF ���,.f Ll , COUNTY OF �� The for o'n instrument was acknowledged before me The f c�n�instrument was acknowledged before me g g g this�V''day of 20by this��ay of 20 by i (Name of person acknowledging) (Name of perso acknowledging) ature of Notary Public-State of Florida) " ature of Notary Public-State of Florida) Personally KnownOR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. :b��AP�''. TORRSeNYARNER cOmmissl0l NOM.91TORI L WAOdk M`(CdbIMISSION#EE114196 �': MY CO-WISSION#EE114196 4 7 3 8-0153 FloridallotarySorvlce,coryi i(407)398.0153 _ FlorldallotaryService,com Revised 07/15 ii I. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS