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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //^��pp�� Date:_ ' 0 ILD Permit Number: 6 LVo 2-- V ID EC E III ED - Building Permit Application FEB 016 PERMITTING 201 Planning and Development Services St. Lucie County, FL 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 dropb ox, click arrow at the end of line PROPOSED`1MPROVEMEN T LOCATION \\ 0 N L Address: `7 (0-3 u EAS�K-7rJ PW 0,P,I Q L)�-� Legal Description: Property Tax ID#: A cc--r IN© • -3 4Zif— S-0 ©100- 0001A0 Lot No. �6q Site Plan Name: Block No. -7 Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED: DESCRIPTION,OFWORK` CO N.e,tzZT4C:_ L4b ( 2' )c. zz 3 PS 1 1 w 1(tc Mots to 11-1 lel STP-U C_V_ l R---C 1N I LL 6 &�f j L—T p t`1 S L CONSTRUCTION INFORMATION Additionalwork toe e orme un er this permit-check.a appy: HVAC 11 Gas Tank ❑Gas Piping _Shutters a Windows/Doors 11 Electric ❑ Plumbing Sprinklers ElGenerator Roof Total Sq. Ft of Construction: S Ft.of First Floor: o-� Cost of Construction:$ CID Utilities. _Sewer O Septic Building Height: OWNER/LESSEE CONTRACTOR , Name o 3zyV- -Fidr2AOtName: Address: ' SS (QA5 buuC &Q 112- Company: City: Po gn- S-r l-lta 1�5- State:�z- Address: Zip Code: 3`PLt Fax: City: State: Phone No. fP� ��7 ' ( Zip Code: Fax: E-Mail: C—AOL t.07M Phone No. 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW:INFORR/IATION 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. a 1 s _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF Luo,i F— COUNTY OF The forgoing instt was acknowledged before me The forgoing instrument was acknowledged before me this 1 day of_ I r 20 ((a-by this day of ,20 by T01-64a�� (Nameaftei: n ackno Ieog'in�e 1_ (Name of person acknowledging) —� (Signature of Notary ublic-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification / Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. r 1 � I'Mu s I) KAREN S. NIELssion No. (Seal) o�pr vt,��. IT Commission N FF 11 �15n =* '' My Commission Ex iN ig PAI JUJIV Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS