Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u Date: C 13� 1 S Permit Number: 15 d� Odl 1 RECEIVE SEP 0 3 1015 ® - _ 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 V PERMIT APPLICATION FOR: PR(*3POSE® IN�PRO\IEMENT LOCATIaN: Address: �� Legal Description: tgC'-t _a—" A Property Tax ID#: a`, 5 J 1 d 3- 6 OCj `�- Lot No. Site Plan Name:S \,QYA Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Maw DETAIaLE�D DE�SCRIPTION (�F WO�RK: � balfilokuAffim x_ COt�ISTR'LJCI'IOIV I�N�F®'RM-A1'I®N: Additional work to be pertormed qn er this permit-check all that appy: _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: $� �U Utilities: —Sewer —Septic Building Height: 0�1AlNERjLESSEE CONTRA. OR Name Name: Address: ?Bol Ry,5 i�4 Company: City:l�l:�A State Address: Zip Code:�%A--) Fax: City: State: Phone No. 08 Zip Code: Fax: E-Mail: L �y uclg fie? A rN).LCL`n Phone No Fill in fee simple Title Ho der 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. SIJPLP11 M5jN L. CONSTRl1CTl'©N LIEN LAW INFORMATION: DESIGNER/ENG I EER: _ Not Applicable MORT E COMPANY: _Not Applicable Name: < Name: '� f') Address: . Address: City: State: City: State: Zip: hone Zip: Phone: FEE SIMPI- TITL HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: A Address: City: City: Zip: one: 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 work or recording our Notice of Commencement. i ignature o Owner/Les ee/Agent Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF - Lyc COUNTY OF The forgoing instyument was acknowledg-1 before me The forgoing instrument was acknowledged before me this '� day of k,�-� 20_ by this day of 20_ by e Oy (Name of person acknowled ' g) (Name of person acknowledging) (Signature of Notary Pu 'c-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produce I - ; Personally Known OR Produced Identification Type of Identification pEANNp Stade o1 F1ott Type of Identification Produced L 10 Y puhltc rtes 6P 16 2p1 a Produced tjgcomm•ExP #EE g58161 Commission No. S C� esto NaGonaXN°�at1 Assn. Commission No. (Seal) gg o';�°�: g0ntted� REVIEWS FRONT ZONING "SO PERVISOR PLANS VEGETATION SEA TURTLE MANGROVE - COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED lev. 7/2014