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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J6� Date:��I LE Its Permit Number: oi Building Permit Application Planning and DevelopmentServices Building and Code Regulation Division cTi-,) 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: _'-L..�_� _ -DZ �©Ll� PUL�-C(El, FL 3 CII Legal Description: 86F 108k"Ir-41505-007ff COf-KA-L C'vvE BE/9-0—P— Se-0-1 -- 131k Z i-or 7 � At, / Fr 6 F mcPfiVy' 4Zy-Y Property Tax ID#: "7(!) 00-D0�'6 .4 OT © Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back:_ Right Side: M Left Side: DETAILED DESCRIPTION OF WORK: a CONSTRUCTION INFORMATION: lona wor o e er orme under is perms -c ec a a appy: ❑HVAC nGasTank E]GasPiping Shutters aWindows/Doors 1�ctric 0 Plumbing ❑Sprinklers ❑Generator ❑Roof Total Sq.Ft of Construction: Sq.Ft.of First Floor: _ Cost of Construction:$ f�0 0 Utilities: 0Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Na me� d bName: _ Address:�Lc �16 AVE Company: Lou.* GL City: �(9�7� � /�(�i/('. _State: Address:11/0/ I510�41V# C Zip Code: Fax: City: T (C�'-� State:��� Phone No. Zip Code: ��'7b � Fax: E-Mail: �^ Phone No. !I�r7a 3-32-q 0 6 ` Fill in fee simple Title Holder on next page(if different E-Mail: _ I from the Owner listed above) State or County License: 6fz#0D/L5-/f/ If value of construction Is$2500 or more,a RECORDED Notice of Commencement 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: FEESIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY:. Not Applicable Name: Name: Address: Address: _ City: City: Zip: Phone: Zip: Phone: I certify that nowork or installation has commenced prior to the issuance of a permit. St.Lucie County makes no representation that is granting a pe rmit will authorize the permit holder to build the subject structure which is in conflictwith any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibitsuch structure. Please consult with your Home Owners Association and review your deed forany restrictions which may apply. In consideration of the granting ofthis 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 CountyAmend ments. The following building permit applications are exempt from undergoing a full con currency revi ew:room additions, accessory structures,swimming poo Is,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNI NG TO OW NER:Your failure to Record a Notice of Commencement may result in your paying twice for improvementsto 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. s —Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA1 � C OU NTY O F S} . �u e CO U NTY O F S�. t�e..t,C.l e The forgoing instrument was acknowledged before me The forgoing instrum entwas acknowledged before me this 19 day of 20 15-by th is 1�_day of ALIQ IASL' ,20 lS by C av s Lov, CvNay _3 1. owe (Name of person acknowledging) (Name of person acknowledging) r ( ignatureofNotaryPublic-State of Florida) (Signature of Notary Public-State of Florida) Personally Known X, OR Produced Identification PersonallyKnown/K OR Produced Identification Type of Identification Produced Type of Identification Produced Commission N o.F IioD'81-in jp ' . Notary Public state iss' n N o.'F F g cl '' N n P�btic state of Florida Ed Flores Evelinda Flores `%�, � My Commission FF 089788 ` My Commission FF 89788 ?�� Expires 0 210 412 01 8 Revised 07/15/2014 . REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS