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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATbN TO BE ACCEPTED Date: Permit Number: Building Perrn�it Appfication Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commorciai Residential PERMIT APPLICATION FOR; To Select from droobbx, click arrow at the end of line Address: VW051 Ar, Legal Description: \AN C% 1W0 Property Tax ID #: d.1 '��.� ©w �`Ou r Lot No. Site Plan Name: Block No_ Project Name: Setbacks f=ront Back: Right Side: Left Side: XT31tional work toe e Orme un er this permit – check all apply: HVAC as Tank ❑Gas Piping _Shutters 11 Electric i — Plumbing Sprinklers Generator Total Sq. Ft of Construction. . Cost of Construction: $ a z,S Name �* Address: City.: State: Zip Code: Fax: Phone No. �1U ` QUA"' Ft. of First Floor: Utilities.:cnSewer Eheptic E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of L1Windows/Doors F]Roof Building Height: Name: vv 'Company: t ` CISA.+ . lnr+ Address: sw VA' v :City: Qo c � �+- Lv.'�_4L- State:. Zip Code: !>J0\%4 Fax:]:) 'YJ -"W601 Phone No. E -Mail' PA wilt) State or County License: CS encement is required. DESIGNS Name: Address: City: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: _ Not Applicable State Not Applicable MORTGAGE COMPANY: (Name: Address: City: Phone: !BONDING COMPANY: ,Name: Address: City: Zip: Phone: _ Not Applicable tate: Not Applicable I certify that no work or installation has commenced prior to the i*ance of a permit. St. Lucie County makes no representation that is granting a permit #ill authorize the permit holder to 'build the subject structure which is in conflict with any applicable Home Owners Assoaation ryles, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do herebtV agree that I will, in all respects, perform the work in accordance with the approved pians, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. if you intend to obtain financing, consult with lender or an attorney before commertoinp- wont or rer.oy i'ng your Notice of Commencemen _ 1 - of owrier/ Agent/ STATE OF FLORIDA COUNTY OF The forgoing instrum t was acknowledged Pefore me this day of 20 1 by 1 i LA bo f` (Name of pers$n acknowledging) Attvt— (tgnature Notary Public- State of Florida PJ Personally Known ✓ OR Produced Identification Type of Identification Produce E17FlG9.3 Commission No. Revised 07/15/2014 REVIEWS FRONT ZONING COUNTER REVIEW DATE COMPLETE INITIALS ,al) BECKY TAI MY COMMISSION it Ider STATE OF FLORIDA r COUNTY OF 6 Ltte. G The forgoing instru)�nt was acknowledged before me this day of 20_y& by Z`Name of person tia' cknowledging ) (Si nature of tary Public- State of Florida } P•,ersonally Known OR Produced Identification Type of Identification Produced c -:c/ G g3 ea I BECKY TAI Mmmilksion No. �[ :3ii` 1' s� 8'103 �,.01 MY COMMISSION f1 SUREVIEWOR I RE LA NS l VREEWON SEA REVIEW M EVIWVE