Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� i Permit Number: _ 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 AC PERMIT APPLICATION FOR: PR,.OPOSED IINFRQ�/°EMEN1' LOCATItON: r 211 Address: ILIel "I/If 'edre Legal Description: /l eG✓ co', kw Property Tax ID#: ��3 ^ 000 ©0017 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 11," '' '' i :.+ P #! R. +` "_' �,�:.$ ,kk", TlOf�0E. WORK" Wo en e e Le rui . l;i . v . ro" d- o 7c rb e G f i_4op _Mt d r& L—f dgp neEy . CO'NS.TpgRUCTfQ�NIN.FORN1ATgl�O e. oM w'am ,k7F k :,avi.d°•, {_ W' ' Additionalwork to be performed under this permit—check all that appy: eg _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: /� Sq. Ft. of First Floor: Cost of Construction:$ �/��' Utilities: _Sewer _Septic Building Height: tk1 ®UVNER LESS E." ' SFr, 'd CONTRA 3 << ._ ,. ,* �d. `� a...-_�" + a K- r s .,i r��x €., `.`''SJ t��.,z,.,'. ..r 4'�=-.:., �§�A" "d"I's" '�.7 a a d�t.7.,. ,h 91 +Ni�` s+!ti._.'�s i.E ,i^ a F. s Name Name: ��?.'p7 qf Address: O .G�/ & t;' Company: City: F;4 eic rc'o State: r'Z- Address: Zip Code: 3 Fax: City: State: Phone No. 77A_ 7740 Zip Code: Fax: E-Mail: O>t j4�e *Ie , CC-.-i Phone No 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. SUHPPLEMENTAL. C©NSTRUCTION HIEN LAIN IN'FORMAT(ON: 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 wor or recordina vour Notice of Commencement. Si atur of er ssee/Agent Signature of Contractor/License Holder TATE ORI STATE OF FLORIDA COU OF COUNTY OF The forgoing instruyqent.was acknowledged before..me The forgoing instrument was acknowledged before me thisoW day of 20 by ' this day of 20_ by (Na of person acknowledging) (Name of person acknowledging) tA-A A31qV_J W" (Signa ure of Notary Pu c-Sta a of Florida) (Signature of Notary Public-State of Florida ) q...„,' ..., s...E.k, .moi+.dq^,�a.-t a. Person ily Kripwn >5�odu e8'Ider trF'tation Personally Known OR Produced Identification �`�� Type of Identification Type ofMibri Notary Public-Stateof FloridaProduc " ' _M Co p r., :. _ . , Produced ct: .�o�:^:x . Co{nmissiun#EE Commi tY"�. -_Bonded Through National Noca.(Se21,) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.