Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST B(E�COMPLETED FOR APPLICATION TO BE ACCEPTED Date: - 7�"3l� 6 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 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line �� PR®POSED IMPR® EMENT LO.CATIONq. Address: -T2H ae2 fi'ee ` IC. - Legal Description: Al e 2 &S l /mssn�,� �yJ C • 3 2 7(F" 1U�® Property Tax ID#: Y 5-0,2 - SO/- 07X 7 - 000 J` Lot No. / Site Plan Name: Block No. Project Name: Jam/ .41691-of Setbacks Front Back: Right Side: Left Side: SDE;TAILED®ESRIPTI®P �J�FW�SJ�RKus Co eAdd C®NS.TRl1,��fl®NINF�©�RfVIATf®'N. itiona I work to be ertormed under t ispermit-check a11 appy: ❑ Gas Tank [:]Gas Piping ing Shutters Windows/Doors — 11 Electric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: yl?zl S . Ft.of First Floor: 4(9 Cost of Construction:$ /70�,n� Utilities:lnSewer©Septic Building Height: �c O''ppV11N ESR/LESSEES g C®NTRACT 4IR,: '� MEW�t�� :F,c..t Name 'q"C Name: i Address: dol 3 �� /,o?Y!i« Aeeleft' 4e. Company: 1 f �(/C• %o1 G. City: State: f'L= Address: O�� Xl zf 5;'e_Aee,- rf Zip Code: 3y9 7 Fax: City: Jest fe'i A.,.CA State: JcL- Phone No. Zip Code: 3� 6- Fax: 7'72-33)_`,Wl E-Mail: Phone No. 772 - 2y/0 's7/y Fill in fee simple Title Holder on next page(if different E-Mail: d G eA /n f Al 1, ;4 C & � •GBr'l from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONS1'RUCl-I®N. LI':EN LAW IN�FOR�MATC®N: 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: 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 work or recording our tice of Commencement. s _Signa re o Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORID _ STATE OF FLORID COUNTY OF____ COUNTY OF QZ_�� The forgoing instru ent was acknowledged before me The forgoing instru nt was acknowledged be ore me this, day of ..moi ,-20/ by this 9 r day of 20 by /I 0641A Na e o person acknowledging) ( e of person acknowledging) 1 _ 0 ffyy (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known _ �OP1ieed'Tder �fjt4NE Personally Known Qfi Pibd -lderi' Type �°a� is- 17'"Type of Identification Prodflce� n T e of Identification Produc °1a i%AWN NfiLUN1-- State ` r omm.Expires _a- {1 °a �o% Notafy ue fc-Staff-51 Florida f ,•:M} #Et 877571 1';. t �' ; •= �� Expires Mar 22,201 Commission No. �l c•. ,v; slon ;; Commission No. y: . (Se h National Notaf , t Y- omission#EE 877571 l �;' Bondedh0U9 . T�1f`.gn Nadona"Aary Assn. Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS