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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /' Permit Number: Building Permit Application Planning and Development Services JAN / 7 2,. 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT'LOCATION: Address: 5OS.5- 'ru--N Pa lee. ice n. %Z.at4-a f=-T- FL 3`155-f Legal Description: Property Tax ID#: ) 3 D 1 ' S c7 0 00 Lot No. Site Plan Name: Block No. Project Name: Ta Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION:OF WORK P-.,? P ea C �,�, �: r TU B �- 1 C S'y S i rA11 CONSTRUCTION INFORMATION. Additional work to be nertormedunder t is ermit-c ec a appy: HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors []Electric Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: r� S Ft.of First Floor: Cost of Construction:$ ���(J �— Utilities:Sewer OSeptic Building Height: OWNER/LESSEE CONTRACTOR: Name LA-lce_wo ,,'- PrLope,- ( 14oQ,_,!iSL c. Name: Se-©T 7- gfl_-� r.+ ;,J Address: 1 CI O Sit) CT-_ Company: DC-150 N A i✓- City: P S L State: If7i- Address: 91 !U a..i Ne wm4n k e-^) Zip Code: �Ll9 6 Fax: City: P State: 'F C Phone No. -7? )- Zip Code: 3 `1 56 3 Fax: B-7 4 -77(3�y E-Mail: Phone No. "7.7 a- 6-7 3 raa C Fill in fee simple Title Holder on next page(if different E-Mail: -�.e _L) nN A i/t_V-e Q J c S Q Al e •con from the Owner listed above) State or County License: i 13 cf S- If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION': 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: 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. s _Signature of Owner/Lessee/Agent T''.....A Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 0 o/ /'z"COUNTY OF M-< n m� The for oing instr ent was acknowledge X The forgoing ins ent was acknowledged befor r e�S this'day of 20 m this day o 20 Z,byCD �m W0 v wox C N?N�T2 C QTS m O 14- (Name of person acknowledging) �N (Name of person acknowledging) a2 J _4aly"IJA A (Signature of No ublic-State of Florid (Signature of Notofi Public-State of Florid ) Personally Known OR ed Identificat' n Personally Known OR P o ced Identificatio Type of Identification Produced ` Type of Identification Produced i ` Commission No. (Seal) Commission No. (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS