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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Bate: Permit Number: '� � r �' . s Dulild:ng PermE Application Planning and Development Services Building and Cede Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34582 Phone: (772) 462-1553 Fax: (772) 452-1578 Commercial Residential , PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION:. Address: 9 or Cv Legal Description: AD ZQA fit T" T7� rzEs�,Qvr f�rfn it f..ac.-� r n,�.-e Property Tax ID #: 33 2i - - p0 6— ©Op. Lot No. arg' Site Pian Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: -rh s4cL (( rteuo S h au v -r ,tcJ v'.e t r 44' ren c� bier b c�-l�h c� r n CONSTRUCTION INFORMATION: jj��ltiona war to a orale un er t is permit — 111f,''!1! a aPA Y' I_iHVAC a Tank Gas Piping Shutters Q WindowsJDoors 1=1 Electric P9umbingSprinklers J� Generator (�, _j Roof Total Sq. Ft of Construction: Sq. of First Floor: Cost of Construction: $ _ � 5`-O i tr Utilities: L _I Sewer Eheptic Building Height: OWNER/LESSEE- CONTRACTOR: Name Name: _ J[ f,P_Dh u4 tr Address:r Company: -Jrk i U S L, City;X4 o-f-Badi State: , L Address: JgQa SC SAin -, zip Cede: gLiqFax: City: al± St, LLic:iC State: FL - Phone No. Zip Code: -?V4 q,!5 -Z —Fax:_7 E -Mail: Phone No..77 ;?7- 3QZ Fill in fee simple Title Holder on next page ( if different E -Mail: Genesssplvm I� N from the Owner listed above) State or County License: Cr_ c kLA vd i 6I' -? if value of c[ nstructionlis $2500 or more, a RECORDED Notice of Commencement is required SUPPLE DESIGNI Name: _ Address: City: Zip: IrEE SIMI Name: _ Address: City: Zip: IENITAL CONSTRUCTION LEEN LAW INFORMATION: fENGIN 'ER. --- Not Applicable MORTGAGE COMPANY: Name: Address: hone: State: City: Zip; Phone: E TITLE HOLDER: _ Not Applicable BONDING COMPANY: Name: Address: City: hone: Zip: Phone: I certify tha� no work 6r installation has commenced prior to the issuance of a permit Not Applicable State: Not Applicable St. Lucie County makes no representation that is granting a permit wit( authorize the permit holder to build the subject structure which is in c nflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. PI aase consult with your Home Owners Association and review your deed for any restrictions which may apply. In considera, ion 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 buildingermit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, simming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWA ER: 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. �gnature of Owner/ )lessee 11nature of Contractor/ icense H r s STATE OF FLORIDA 1 STATE OF FLORIDA COUNTY OF Sri L,,` �_ COUNTY Of SL The forgoing instrument was ,a I11 knowledged before me The forgoing instrument was acknowledged before me � this _ clay of _ &j ` i �� 20 JLbY this 31 1 20 __L6._ by (Name Personally Kno-n _ —OR Produced Identification Type i#+cat-iSn Pr duced Commission No. (Seal) Revised 07/15/20 REVIEWS IFRONT COUNTER DATE COMPLETE INITIALS rM 5-1 Personally Known F SOr4 oom QR Produced identification Produced Commission No. (Seal) ZONING, SUPERVISOR IPLANS VEGETATION � S REV EWLE t MREV ROVE REVIEW REVIEW REVIEW REVIEW