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HomeMy WebLinkAboutBuilding Permit Application Y\All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: szel l fir 600 _ 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 l/ PERMIT APPLICATION FOR: �,�izn� PRO-POSED I�NPRO1/I?M'ENT LOCATION: a� Address: Legal Description: 0&�7 —lam- '57—_ 0'C-'e1Cf z i 4 DexIS' Property Tax ID#: lz F Lot No. Zz Site Plan Name: Block No. Project Name: /_5 P J _ Setbacks Front_ Back:/,Z. 2S Right Side: • 0 Left Side: 13r° 615 DfT�A1LED DE�S�R�IPTION t�3F 1NORK: l CONSTRUCTION INFORMATION: Additional work to be performed under this permit—c ec a tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors ,,-dectric —Plumbing —Sprinklers —Generator —Roof Total Sq: Ft of Construction: Z©� Sq. Ft. of First Floor: ! Z d Cost of Construction:$ / ��� Utilities: —Sewer peptic Building Height: %OVUM ER jLES`�S E .: C® ,TRACTO.R Name �X le L/ sG��Gr !�—���5� . ., �. : :,,;r;•,; Address: //6� s�w Z144 S / Compa4: City: A4111n State:�f Address: ,t+ Zip Code:3 yQ 4 P Fax: City: State: Phone No. '41s'g `r Zip Code: Fax: E-Mail: RZy %V Pe-tei��/�� /�/C! Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or Co un License If value of construction is 2500 or more,a RECORDED Notice of Commence ent is required. UPP EMENTAL CO,N4ST f,UCTION LIEN LAW INFORMAT ON: 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-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. Sig ature of O r/Le see gent Signature of Contractor/License Holder STATE OFTLORIDA l STATE OF FLORIDA COUNTY OF / ����� COUNTY OF The for oing instr rent was acknowledg efore me The forgoing instrument was acknowledged before me this�day of 2(X4(.0 by this day of 20_ by (Na of perso a knowledging) (Name of person acknowledging) (Signature of Notar P blic-State of Florida ) (Signature of Notary Public-State of Florida) Personally K OR Produced Identification Personally Known OR Produced Identification Type of Iden is Type of Identification Produced i° °''- 6ELA-M`HUFF Produced 2 . • State of Florida Commission N Commissio (S'�s a�O:'M m1p Expires NIay2019 Commission No. (Seal) """•" Bonded through National Notyy Assn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /2014