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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / Date: Permit Number: RAU �©ou 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: PROPQSED INPR:OVEMENT LOCATION „E / s. Address: 6'(110 a l f'�.+,veb, gU'- Legal Description: Property Tax ID#: V/0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION 0'F UVORK M _E CONSTRUCTION [NFORMATION Additional work to e pertormed un er t is ermit-check alltat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors IZ/Electric —Plumbing —Sprinklers —Generator —Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ /SGcI Utilities: —Sewer _Septic Building Height: OMER/LESSEE CONTRACTOR a Name JUJU Name: Address: 61910, �� l�eticl�, Gw✓ Company: ,/6': �''r//w�_ ��� r. " City: T �/ -P+CR_ State:r Address: /yn c/ 1414 Lr, Zip Code: 3 y9 Q 2- Fax: City: State: Phone No. 30S i/ Zip Code: _ ` g�7 Fax: E-Mail: Phone No -7 7 6 S-2/ Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License I3l Ltt of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIE"N LAIN INFORM�ITION a" 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. Signatur of Cikvn essee/Agent Signature of on rac icense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTYOF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 'V day of a5j\, 201.6_ by this y day of � ,20jJ, by —V�76CioflU (Naht6 of person ack wledging) (Name of person acknowled ing) (Signature of Notary Pu lic-State of Florida) (Signature of Notary Pub' -State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced produced Commission No. S'e I SHAHNA\N of 001161mmission No. NOVA�fY�pmbEXpUes Qe 12112A 8 �PSHPNNP$1a a°MD 2p18 . re° Rfissf° o\aty „„„ s a �0 ona\N •a ��,�,,. Notaf`1 Ex4`f FF All2Q REVIEWS FRONT r F Ggonde U84`1�' also "'" PLANS VEGETA�I.'Q 1 _ \ sip° �{�1Q6���, COUNTER . ' Rl tl' ' EW REVIEW REVIEW .; EV ��z\,o r t 1. r•,lh a,,., REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014