HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:.. . ' Permit:Number: (0 t9 7 U
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Building Permit Ap ' lication APR2.' 016
Planning and Develooment'Services
Building on'd Code'Regulation Division
2300 Virgniio Avenue,Fort Pierce'FL 34982
Phone: (772) .462=1553, .Fax:(772)462-1578. CommercialR251Glentlal
PERMIT 4PPLICATION FOR: To.Select from:dropbox, click- at the end of line
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PROPOSED IMPROVEMENT LOCATION:
Address: .
Legal Description- Xld'QYI 113�1f''
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Property Tax_ID.#�' =LOCAL� ��"a Lot No:
Site Plan Name: Block No
Project Name-,_ t
Setbacks _:Front _: Back: Right Side:. Left.Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional,work to be nerformed. under t is,permit=check all Vh&t apply:
HVAC El Gas Tank Gas Piping Shutters: +Windows/Doors.
Electric.: 0 Plumbing Sprinklers GeneratoRoof
l r.
TotaLSq: Ft=of Construction: S . Ft:of.First:Floor:
Cost of Construction:$'(O ���� Utilities:- Sewer Septic Building Height:
OWNER%LESSEE: CONTRACTOR:
Name Name:. D4 4y.d AS
t
1.
Address: - . Y Company:.
Cit r P�IC1t. State:., s:; 'e Y
Zip Code��- Fax: Cit State:
Phone No ACU q(O�� .� 6 1 � Zip Coder Fax;
E-Mail: Phone N�
Fill.in fee simple.Title Holder on.next page(ifdifferent E-Mail �i11 LOW'
from the.Owner listed above) State.or County License: _ 1
. .
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN ER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable.
.Name.: Name:
Address: Address:
City: State: City-: State:
Zip. Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not,ApplicableBONDING 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. lf.you:intend to obtain financing, consult with lender or, an.attorney:.before
commencing:work or.recording your Notice.of Commencement.
s
_Signature of Ow er/Lessee/Agent Signature C ctor/License Ho der
STATE OF_F�tIDA STATE OF.FLe IDA
COUNTY-OF COUNTY OF �� .�(1�1�.
-The.for oin i*nstWmnent.was acknowled @@ before.me The forgoing ins ment was acknowledjgd'before me
this day.of 201 Ab this day,of 20``+l by
NICOLE OBEftrifrt' .. tPar r� NICO
Y1r1 4 .
Ef�REi'aER.
.(Name of person ackn edging) EXPIR �, pril 13,2cn :(Name of perso777
�FF 112175Bonde. ruBudgetNoWry$ervc: EXPIRES:April 13,2018
OFFS onded Thr=Budget Notary Services
(Sig ure of Notary Public-State of orida). _ _ —-( i ture of Notary ublic- ate of Florida)
Personally Known OIC m ced. dentif!cation Personally Known: . OR Produced Identification
Type of Identification Produced I>-� 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