Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ( l 0 6 Permit Number: RECEIVE • Building Permit Application LIAR 10 2016 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: PROPOSED IMPROVEMENT-LOCATION: Address: 0`1)0 5—. �T Q— Axle- I' + II -- �/ Legal Description: Rev v �W o o d Ac r,_5 ` 5 13 / T - dZ �O T�$ 3 C ( Property Tax ID#: u� o 0012 —00'6 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF.WORK:` S 3 O O C-1 2 c 0.4-er 2F` CONSTRUCTION.INFORMATION: - :Additiona.1w,orktobepertormed under this permit—check all that apply: HVAC :. _Gas Tank, Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total'Sq.Ft of Construction: Sq.-R.of First;Floor: Cost of Construction:$ �D �fN0 Utilities: ? Sewer ` Septic'. Building Height: OWNER/LESSEE: ., - ..: CONTRACTOR: - - .- Name r� D aVL I Name: Address: .1QR9 (1S /`Fw4 Company: City:i�c `��I-PcrC� State: Address: L/7/ � s 0S �Sr Zip Code: 36tj© {{ , Fax: City: /�O P,-C f-'C -e— State: Phone No. Q I� (] Zip Code: �/j'b'�. Fax: E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: -e- �U✓+^ �) 1`2 from the Owner listed above) State or County License:. I-P�`/ If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 commenc'=work or rec?14ing your Notice of Commencement. S _Sign ture of Own r/Lessee/Agent Sigogiture of Con actor License Hol STATE OF FLO ID N STATE OFF LORI COUNTY OF , ��' COUNTY OF N =LL� 6. The f r oing instrument was acknowledged befo 2 The forgoing instrument was acknowledged bef this�day of 20/ =o� this //on day of M).0�2Vq 20 b =z a _o M OQ 2 Q0. w_'Lu g ¢UX CrewJ off¢z ame of person acknowledging) m ( me person acknowledging) :440. LL (Signature of ary Public-State of F rida -'' «,;gtF' (Signature of ary Public-State of Flo i a) 'q N•...:h3 Personally Known OR Produced Identification Personally Known OR Produced Identi ica io Type of Identification Produced Type of Identification Produced Commission No. (Seal) Commission No. (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS