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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAPLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I�O Date: I l� Permit Number: 0 -- - -- -- 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: To.Select from dropbox, click arrow at the end of line IMPROVEMENT-LOCATION: Address: i .J.Q Z Legal Description: Property Tax ID#: S!I " S() ©y O 1 U " sc— Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION 'OF WORK LLi.v e 'Dr� 1 N�e e--x,-c Imo Q_X 14S (n Ic 5 -��n . �•S •,i�,� l�i � ten_ �%�k� QNSTRVCTION INFORMATION -Y Additional work to be nertormed under t ispermit—check all that appy: HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors Electric 0 Plumbing Sprinklers Generator F] Roof a� Total Sq. Ft of Construction: SFt.of First Floor: �>0e UtilitiesSewer Septic Building Height: Cost of Construction:$ 4/6 .OWN ER/LESSEE CONTRACTOR: Name'� Name: Address: 12 n ,., ^ Compan ( ( )f1 City- P `C X ��Y1 State: Addre/sss: Zip Code: Fax: City: State:6--- Phone No. Zip Code: Fax:RI E-Mail: Phone No. _ - S Fill in fee simple Title Holder on next page(if different E-Mail Ll C from the Owner listed above) State or County License If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN,LAW IN,FORMATION:; ` 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 commencing work or recording our Notice of Commencement. L \ S _Signature of Owner/Lesse nt S4nature of ContractoF/Lic 2016 der LL r ` STATE OF FLORIDA �_ FLORIDA COUNTY OF � � ��, COUNTYOF The forgoing instrum nt was acknowledgeq Wore me The f.rgoing instrument was acknowledged before me this day of Uc�t 20, y this ay of I"\cN—. 20 �_Gy (Name of person acknowledging) (Name of person acknowledging) A Ali ay\'_C ��A (Signature of Not Ii -S ate of Florida) (Signature of Notofi Public-State of Florida) A' \\11111, (� O�PRV pie, ;ti Personal) Knoinin o 0 r ��� Ntiilllcation Pe a Known OR Prod d dentifff'���ti n Y Dear ` � � S e of Flo T e pf\\\E n roduced Type of Identify o duce Iic ��RrP, :ter oP: 234730 ` ° °�� '.,For i1pP• My Comm.Ex it ' '` : ANOE """ Bond rou hp �YS427,2019 CoF_n F i ;19oNotarF eal) Commission g Nah nal Not °•State of arYAssn. ,�.o nay Commission#F Florida nded gh Nal onMNo 7 A Revised 07/15/2014 2o1s "s�,,,.•,.� Ssn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER . REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS