Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 4- -1' ��D Permit Number: o zb �, EAU /�]]� Building Permit Application APR 1 a 1016 Planning and Development Services PEP, . Building and Code Regulation Division St iTTi �G Lucie County FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ PERMIT APPLICATION FOR: PROP05ED (N,WROUEMENT LOCATIQN � ! 'Address: d 2ceO 16:' Legal Description: 5 J n Q JLC -FQrY1 l J U t-lO m-e— E :Property Tax ID#: 2 50� 6900'.:� eq(9 o No. Site Plan Name: !Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK ' CONSTRUCTFON .. (NFORMATIOIV " � . . Additional work to be performed under this permit-c ec a tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof i Total Sq. Ft of Construction: '7© Sq. Ft.of First Floor: Cost of Construction: $ /�,6 7 Utilities: —Sewer —Septic Building Height: owNR .E� E' CONTRACTOR . Name ©lJe.f'�t. ...f 1r'1"dam rS o l' Name: i Address: 'aI662) l._GIZ _ 06Mmb(D� Lr Company: i City: If're-6 State: FL Address: so- Zip Code: .3`/ C? 'Ei Fax: City: 1 State: ?14— Phone No. 7 -]'Z 577- 02 r/(� Zip CoderV Fax: 419&6 I E-Mail: 9 ,n GL_'r'r1 t GCS C_c)L C dYYn Phone No P3>79 Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License IIf value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I SUPPLEMENTAL CONSTRUCTION LIEN LAWI.NFRMATION 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 worM recording our Notice of Commencement. en' Signature of Owner/Lessee/Agent Signature oTtontractor/License Holder -. STATE OF FLORIDA STATE OF FLORIDA i ` COUNTY OF ��(` COUNTY OF �� h—ucve, The f rgoing instrument was acknowled a before me The forgoing instrument as acknowledged before me this day of EQ(-1\ 20�by this(day of / ,20_& by I � rs�'b� (Name of perso�n acknowledging) (Name of person acknowledging) >A CL ' (Signature otary Public-State of Florida) (Signature of Wary Public-State of Florida) Personally Known OR Produced Identification/ Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced YN d ptA1N0Y �amie CeUIICh ion No. SiON a iF' 1� Commission No. = e _ COMMISSIO J Mao F ebruwV Q, EXPIRES: SO. 3, 2018 "•,....• ° 53 nen, ja . REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEQTURTLE . MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.