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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST ECO PLETED FOR APPLICATION TO BE ACCEPTED Date: � ,j Permit Number: Building Permit Application Planning and Development Services Suilding and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial l/'— Residential PERMIT APPLICATION FOR: To Seliect from dropbox, click arrow at the end of line PROP05ED IMPROVEMENT LQCATIQN { Address: Legal Description: /?r�Tt2°� L�-�-'��D�5 Property Tax ID#: 3Y/-S'7-67-0/" C.)0�/Z ® 45<:>O/ Lot No.T Site Plan Name: /�./ UleSIA] Block No. Project Name: tbacks Front Back: Right Side: Left Side: D�TAItED DESCRIPTIOl� OF',Vy0RKt CQNST RUCTION INFORMATIQN A01ditional, workto e e orme under this permit-check a appy: HVAC []Gas Tank as Piping _Shutters ©Windows/Doors �]Electric _E1 Plumbing ESprinklers Generator Roof Total-Sq- Ft of.Construction: S . Ft.of First Floor: Cog of Construction:$ 'l� g�� Utilities:Sewer Septic Building Height:T ODUN LESSEE CONTRACTOR Name 6D-U0 PAfZ4C M 67- -'N '� Name: Address: Company: �ei City: L- _State-._, Address: t17 ,ee n Zip Code: 3��SZ Fax: Il.) City: __R State: Phone No. ��G = L/ 'D Z) Zip Code: Fax: E-Mail: A /- Phone No. Fill in fee simple Title Holder on next page if different E-Mail: J`t}-�C� `w` c��. -`I'�N act. C00") from the Owner listed above) State or County License: "C. 1� L-C- ZCo SCO If value of construction is$2500 or morl,a RECORDED Notice of Commencement is required. SUPPPL EMENTAL CONSTRUCTItJN{LIEN LAW iNFORIV1AT1aN. T DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Appligable Name: Name: Address: Address: City: Mate• City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City:Zip: Phone: Zip: Phone: I certify that no'work or installation has commenced prior to the issuance of a permit. St. Lycie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Own$rs Association rules,bylaws or and covenants that may restrict or prohi4it such structure.Please consult with your Home gwners Association and review your deed for any restrictions which may apply. In consideration of the granting of this regtlested 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 exerppt 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 fqr Improvements to your property.A Notice:&Commencement must be r corded and posted on the jobsite before the fir ction. If you intend to'obtain financing,consult with lender or an attorney before commen ' wor or recording our Notice of Commencement. s _Sign ur of Own Lessee entature o o tra or/License Holder QU F FL IDA / STATE LORI DA T' COU OF— The 7day ing instrumer was ckn wledgeq before me The forgoing instrurn nt was actnowledge.d,pefore me this of 20/-J--by this�rtlay of ` .20 by (Name of person acknowledging) (Name of person acknowledging) (Signaturk.of Notary Public State of Florida) (Signature of Notary ublic State of Florida), Personally Known 1-�011 Produced Identification sonally Known OR Produced Identification T _ Type of Identification Produced. o ced MARY410 MARUut s Commission Na. ( ^,~ •�` St�el�ry Politic'Mate a!Flo d missions°. �e�� ANGELA MtI) �=MY Comm�xPUes OQc 2g• U N* a,E ubl(c-State o!Florlda ' Cornmission#FF Comtniso lon#FF 9798; A ^aa;:My rnrnM 234730 moa ii '', ;., Born n Ivfd 019 1 d through Nation Revised 07/15/2014 National Notarygssr. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANQROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS7:1