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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ca�f1 I 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: � ,a.� � � b Address: / / - ' / i Y--�- S 4- Legal Description: Property Tax ID#: 3 yl9",✓��S- 6 d, J00 Lot No. Site Plan Name: Block No. F Project Name: Setbacks Front Back: Right Side: Left Side: 57'-4r-J- e4-t !'eek Le.F7- Go,-,' -r-1- e r 'A�v 5 e as 1-6 Oac.K ProlJlr7Sy L% c- 7-ur-ri_ 20 7-0 ka-c./e 7V✓ n o ck/o n.q `h-` D r oro er f' u,-r% ov d '. z) to Cron` /Q,'�,/�' - ifor*nr O l--oV.S r �y/ le)"D..L1,Or, of itiona work to be pertormed uncler this permit-check all that appy: Mechanical _Gas Tank Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ CEJ Utilities: _Sewer . _.Septic; ,' "Building Height: Name . DName: Cro Address: 3 f u.ra� v� _ Company: Pr/ l �',I II `al ,nex " City: pc5 Y� 5�-j-(,t,C�/ '�_ State: f` Address•17 cl d W S i ro ✓ ti '61PICIL Zip Code3 Fax: City: PO r 5-1'-• L lLCc, State: l' Phone No. /�' ' 3 Zip Code:-3 Fax: �B a E-Mail: Phone No. 7 ;2 - ,3y 0 - lo VS— Fill in fee simple Title Holder on next page (if different E-Mail: 49,'e,te Y 9 �Fe R/O�©ZO Ci e�'/J7�� 'u from the Owner listed above) State or County License: (9 If value of construction is 2500 or more,a RECORDED Notice of Commencement js required. p 1 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-residentialuse 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 Agent/Lessee Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA `9l� COUNTY OF .IAL Lu." COUNTY OF The forgoing instrume t was acknowledged before me The forgoing instrument was acknowledged before me this 044-day of 20L1 by this fc*day of Fe, : !U . . ,20 la:by C� (Name of person acknowledging) (Na a of person acknow led Ing) th-LLIJI (Signature of Not y Public-State oraF171.ma (Signature - •` LA HUFI GENA L �i �� Nola Publg' S ,p,f,Fl,,pri da , (� Personally K" OFl`��r�iu6�I�e�R�lfica 'on � pr' Personally ®_ gAJj0 gb W%1fJdica n Type of I ti ,A,ddL� n#FF ?a19 LcG - Type of Id qg� _ • .__ �0m votes , Bonded through National Not Assn. GMT 1 Commissio My c0m ,� t� '�'; �tSeal}'� Commissi _ 1•.�,, all 'REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. e