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HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC E INF7 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Mme. s I J 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: To Select from dropbox, click arrow at the end of line PRQPQSE© I PRQUEMENT LOCATIQN: Address: 6 n Legal Description: '�_IJF\tl� L® 761FVU LU �/Z O� L-0 5 PropertyTax ID#: 3 'low vol- ©o C( —C>©°- Lot No. Site Plan Name: Block No. 6 Project Name: Setbacks Front Back: Right Side: Left Side: 11111p, all—- A00ilJ�ETAlLED ®E�SCRdIPtI"0`N • lWil=MK ' ti_ Wool C®'NSTR�UCTI`®N tNFORMATI®N:: Additional work to be nertormed under t ispermit-chieck all appy: HVAC Gas Tank Gas Piping _Shutters Windows/Doors Electric ❑ Plumbing Sprinklers ❑Generator _-Roof Total Sq. Ft of Construction: ��Q S . Ft. of First Floor: Cost of Construction:$ �, OL�� Utilities:nSewer Septic Building Height: , N:MR/WSRSEE: C®NT R 4C®R: Name- Cnl� � 2r�arm Name:_ - i3 �e�\�0 Address: - �.�. ,. 2 ��ti Ocwe Company: 4__ City: or c cam: State:-�C Address: �2�0 oS�.o �� Zip Code: 3 � p 7- Fax: City: 1 tr'o State:l:�:_C_ Phone No. -17 a 3 r� �( � Zip Code: 3'2--q 6"L Fax: '966 71 d2��1 E-Mail: Phone No. �T-) �O Fill in fee simple Title Holder on next page(if different E-Mail: &ll U,r5 c o -' from the Owner listed above) State or County License: 00 6 ct,(Zq If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENI'P►LCON'IT RIl1.CTl:®N I' NMEARF®RMAl'I®N: DESIGNER/ENGINEER: _ of Applicable MORTGAGE COMPANY: L--Iq—ot Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ of Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 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 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 Sign atur C c r/Lic se Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTYOF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20 _by this I-) day of&fe20 L by 1s�� (Name of person acknowledging) (Name of person acknowledgin (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known -___0R Produced Identification Type of Identification Produced Type of Identification Prodt 04�Y PV9 Commission No. Seal Commission No. =_; *�= N5ya ublic-State of Florida ( ) _ . .•2 MyfCOmih.Expires May 18,201 Commission#FF 086006 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE y�2zl�s INITIALS