Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE IN/FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j Date: I' 1 r I(D Permit Number: --_ - JAN /8 2 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: To Select from dropbox, click arrow at the end of line PRQPO.SED.IMPROVE MENT LOCATION Address: -EB1 Legal Description: IV('4 es Tsliand Property Tax ID#: 460a- 50i- /02a- Ccc- h Lot No. Site Plan Name: Block No. Project Name: Z' Setbacks Front Back: Right Side: Left Side: DETAILED.DESCRIPTION OF V1/OR,K: : (2V) - e_ aJc� f2 Ince-men aok 4 (P 0 �QTC)n 143e_or , PKk0QC UnJ &em CO N STRU_CTIO N•_I N FO'RMATI:O N Additionalworkto a er orme under this permit-check a app"y: DItWAC E]GasTank Gas Piping Shutters Q Windows/Doors 11 Electric 0 Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ 3 ©� Utilities []Sewer Septic Building Height: :OWNER/IES.SEE: CONTRACTOR = Name11 tori- r- Name: r S Address: 2W Neffles-E)XVd. Company: City:denbeq-FOn State:FL Address: rZ40 S M) I 1 ew Tr" Zip Code: rr5496�� r vv��Fax:r _ City: M _BCh to :� Phone No. ,9 'Of 1q(P• Zip Code: � 5 Fax: - U E-Mail: Phone No. 1 -CD19 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. SUPPLEIVIENTAL.CO.N'STRU.-TION LIENIAW,INF.O'RMATION 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, consul ith lender or an attorney before- com 'n?ing work or recording our Notice of Crnmencem s _Signature of wner/Lessee/Agent Sig ur of o cto /Li ense o STATE OF FLORIDA STATE OF FLO IDA COUNTY OF COUNTY OF PB The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of J 20 Llipby this a day of 20 _/_�by �Y1 rl U ► nes Dior k 1/i nes Lon acknowledging) (Na of person acknowledging) (Signature of Notary Public-Sae of Flo r d ) (Si nature of Notary Public- ate of rida ) Personally Known��OR Produced Identification Personally Known 1/ OR Produced Identification Type of Identification Prod wrpd Type of Identification Produced Par PUe Lisa Rodriguez Fv P Commission No. z° �o NA*P4ubIIC-state of Florida Commission No. osr �e� �r dRosriguaz N C Commission#FF 917447 Not ry u lic-State of Florida n c Commi_: ionttFF917447 -19 �o F OFF1.0 .gni - eP- Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS