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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFQ MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Ypylp 1'^WL .^�91Y%S _ 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: �m cc) PRQPOSED LNPR©UEMENT LOCATIQN: n_ Address: —T r4�A � <�i \/-� cVY��- ��Q�cQ .Legal Description: �� $ri l(h t( , -kence.) Property Tax ID#: I 2 ' I (D - o0o - Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�;CRIPTION tJF WORK: .Q 10 I-P �V 9'af e Sb UJ-h S i el Q- ,*NINAFORMAT(0N: itional work to be,pertormed under 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: $ 1 000 Utilities: —Sewer —Septic Building Height: WI\I�ER./lLE=�S�SE�E: G©N1"RAOR: Name n Name: OWn 2G' Address: D Y Company: City: - �� `�(cc G__ Stater Address: Zip Code: Fax: City: State: Phone No. 9,,5q ) :3 T� Zip Code: Fax: E-Mail: I _ mf�IT(fmq ac@O.cLc4r)n-1 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. SUPPLEMENTAI. CONST, RUCTION LIEN LAW INfFORMATION 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 work or recording our Notice of Commencem ur of 0 n r/Lessee A nt *gip•, na ure of on actor Licens older STATE OF FLOR •• STATE OF FLORI tor•, COUNTY OF "t� COUNTY OF ._ R Cn� The for oing instru ent was acknowledged �o o The forgoing instru ent was acknowledged b fire me this day of 20n by o � this day 20, E xj a J •°Dc Z3 z mem C.��'i �� •tea`° v m S (Name of person acknowledgin ) �N (Name of person acknowledge ) mT T= OA CQ �v (Signature o otary Public-State of F rids) (Signature of Not Pu lic-State of Florida Personally K own OR Produced Identification Perso ly Kn n OR Produced Identification / Type of Identificatio <� Type f Identifi ati n Produced t' Produced �. Commission No. (Seal) Commission o. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014