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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: `j Permit Number: - 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: rD 14e PROPOSED INiP�RO+UEM �N LOCATI,�� : T, Address: �~ gl� �rive�izc ��►� .Lt Asa ✓ Legal Description: 2"Vdi , /� - /oma �� ,�0 Property Tax ID#: 3 6 al k, 3 61 Xl la 06 /d Lot No. oma 7i d� Site Plan Name: y� Block No. Project Name: ,�,G����'AacrLC Setbacks Front Back: Right Side: Left Side: DETAILED OE�SC IPTION OF WORK: 1' - G d p2 cdc frI&A C(�7NSTRaUCT(O , I� FORMATION: Additional work to be peff6rmed under this permit-checK all that appy: Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors �C Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft. of First•Floor: Cost of Construction: $ Utilities: _Sewer _Septic Building Height: 011VNER/L�S�EES e CO,N,TRACT�;C?R• Name Name: Address: Company: p Y: City: State:_ Address: 1/1 ;? Zip Code: Fax: City:,A0,u1 6-K State: Phone No. Zip Code: 3 �0J-�?-z- Fax: fl y,-!6 -��v�� E-Mail: Phone No J9.,X- 9 X-5 0l c 97>-'a--O Fill in fee simple Title Holder on next page (if different E-Mail G Cc,_ r, 4 � from the Owner listed above) State or County License o-�-C) if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENT'f�l.C©NSTR�UCTI©N LI'.�N LAW I�N'FfJRMATION: 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 thepermit 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 Agent Signature of Contractor/Li nse Holder STATE OF FLORIDYi �• :'%�;,...•NAS' F: STATE OF FLORIDA COUNTY OF COUNTY OFo•. m 0 The f oing instrupWt was acknowledged bef a n The f r oing instrurf nt as acknowledged before � m j this day of 20, b 2 this day of 2V by g: mg;j 2 mz a eL (Name of person acknowledging) (Name of person acknowledging) _ �a m R N 9 zi��TT77 i, co;K N ignature o ary Public-State Florida (Signature o otary Public-State f Florida Personall Known OR Produced Identification Personally Known OR Produced Identification / Type o dentio c n Type of Id ntifi io Produced Produced Commissio u_'� (Seal) Commission N (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.