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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: \\ Permit Number: Or-. :- RECEIVED NOV 12 2015 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: �j•� � PR©hOSE1 IN�PROVE SENT LOCATIO Address: to 10R SDfL)C ('iy2 fob PI9-<_CL 3q9 -2- Legal Description: Property Tax ID#: 3q[) 2-- a/Q -0 Y2--S - Oa O - -7 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: AIMED]& RIPTION LOF WORK: CONSTRUCTION INFORMATION: Additional worK to be pertormed uncler this per -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: $ Utilities: -Sewer —Septic Building Height: @E MR CONTRAC'�7'®R: Name Name: Address:_ (0109 SD�UC•e 1)Y-i V--e.. Company: City: i e Ce_ State:EL Address: Zip Code: S(401' ?Z Fax: City: State: Phone No. 7712- _S-79-1 R 13 Zip Code: ax: E-Mail: irUp.Aa('✓b-eT 9 7 0Phone No Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or Cou y License If value of construction is 2500 or more,a RECORDED Notice of Commenp4mient is required. SUPPLEMENT . CONSTRUCTI©N h�� LAW IN�FORM�►T10N: 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 Commencement. Signature of Owner/Lessee/Age t Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5'-. Lyc COUNTY OF The forgoing instrument as acknowledged before me The forgoing instrument was acknowledged before me this)i'X,day of 0 20�5 by this day of 20_ by w. La 4 -aA (Name of person ackn ledging) 0 (Name of person acknowledging) (Signature of Notary P lic-State of Florida ) (Signature of Notary Public-State of Florida) Personally Known OR Produced 1 tion Personally Known OR Produced Identification Type of Identification p NNP \� °\E\°` Type of Identification Produced V L— EP\\° s�a�¢�16,2��6 Produced PU"".,, Nota mcn ExP��¢S EE85a�6 ssn. . Commission No. t. FDt�Y�° m( �)�# a\N°\any A Commission No. (Seal) i:: •o' Cocnth`pU9h airon REVIEWS FR ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.712014