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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR QPPE.iCATlON TO BE ACCEPTED ���� Date: 6 i Permit Number Building Permit Application Planning and Development Services Building and Code Regulation Division r 2300 Virginia Avenue,Fort Pierce FL 34382 Phone:(772)46e-M3 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line :PROPOSED IMPROVEMENT LOCATION: . Address: pA� 1hQr ),__TCrC P__oyk `�� UxLk r-, Vl s3LNHU0 Legal Description�lC�,L�P 66 �1f3.! PropertyTax lD#: .t- C)�-OCt��'�(7t`�' Q Lot No.�� Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: QETAIIrE©DESCRIPTION,OF WORK: `.. .fi aA c� ick` Aek c c- UZZIC.�rec c' CONSTRUCTION INFORMATION:. ions wor to e e orme under this permit-c ec a appy: ' [J HVAC E]Gasiank []Gas Piping _5hutters� I,Windows/Doors EM Electric [.YJ Plumbing OSpriniders Generator Roof Total Sq.Ft of Construction: So.Ft.of First Floor: Cost of Construction:$ utilities: Sewer E]Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name � Name- AddressS t;xc\e_n n-yen 3 C` Company: fAmcx city: W_ C-D ,C- Stater Address: Zip Code:,W T Fax: City: . L h,u-p— Stater Phone Nola. - �C3 - - Zip Code: Fax{' _;A _ E-Mail: Phone N 1U %n-14 l_ Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: � ` - iy�_.A If value of construction is$2510 or mere,a RECORDED Notice of Commencement is required. L d 098L6L8ZLL 6uigwnld eoio40}sii-I e 19:0 6 9 L 9Z 100 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: Oty. City: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St.Lurie County makes no representation that is granting apermlt 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 worts 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 impro�em nts to your property.A Notice of Commencement must be recorded and posted on the jobsite b fore first inspection.If you intend to obtain financing,con It with lender r an attorney before co ncin workor-seiffording your Notice of CommencemenTz ACl l� op— SiJoafure of Owner/Agent)Lessee igna a of Contra 'cense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF T. ` COUNTY OF The fo of instru ent was acknowledged fore me The fo of instrumentw a acl owledged Ware me this�y of 20 by this,'r da of , 20y (Na o p10 n acknowledging) f 1 (Name of person acknowledging) �i� �L (Signature of Nyv blit-State of Florida (Signature of Nota Public-State of Florida) Personally KnoOR Produced Identification Personally Known 011 Produced Identification Type of Identifiroduced Type of Identification Pr aced Ile Commission No Cc ` ;ib:' 'fal] NA Commission No. E� MY CY LEP LA GFORD a�•` EES 1, XPAE83U242 Revised 07115/2014 /Q07%999 0153 Florio OctobQr 12,2076 l aua,ur a SXpf� �SSI� C'fiC O allotarvSu^Rce. �S O� �Fii•.. 16 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE M COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Z•d 099L6L9ZLL bulQwnld 8010140 ISJI� 13 L9:0 L 9 L 9Z 100