Loading...
HomeMy WebLinkAboutBuilding Permit Application COMPLETED FOR APPLICATION TO BE ACCEPTED ALL APPLICABLE INFO MUST BE COM /�e� Date: Permit Number: ILV©,'f/" W3 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 K PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED LOCATION: 4,! ?I Address: Legal Description: Property Tax ID#: (3 �i ' � G�6 ` i! Lot No. Site Plan Name: Block No. Project Name: I" Setbacks Front Back: Right Side: Left Side: i. DETAILED.DESCRIPTION:OFWORK:`' hEt 1G'� 7 � I CONSTRUCTION INFORMATION: ;' kk Additional work to be performed under this permit—check all that appy: j; i ❑HVAC Gas Tank ❑Gas Piping Shutters LJ Windows/Doors Electric 0 Plumbing E]Sprinklers Generator 1 Roof Total Sq. Ft of Construction: ,,te�ll Sq.Ft.of First Floor. Cost of Construction:$ 5vV Utilities:n Sewer Septic Building Height: ''OWNER/LESSEE: CONTRACTOR: ' . .. ,< Name ` C Fdl Name: fVd-n �v2+" Address: qqI.$ t Company: City: WT ".gtc Q State: L- Address: 64( $V Zip Code: 3 41sT Fax: y� City:rn,r��ifi�li�,' Stater Phone No. LI A 7 61 � Zip Code: Fax: y� T— E-Mail: /U Phone No. 799 d5' Fill in fee simple Title Holder on next page(if different E-Mail: QCG�/ S' w 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. i, SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ii J DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: i State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: !! _Not Applicable I 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. d 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 respectsi perform the work in accordance with the approved plans,the Florida.Building Codes and St.Lucie County Amendment's. 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 commen in work or,record in our Notice of Commencement. 'I s _Signature of Owner Less A nt Signature of ContrYttlrolder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S� �. COUNTY OF 'SI'L-Q, - ,sZ The forgoing ins rument was acknowledged before me The forgoing instr ent:was ackl owledgebefore me this Al day o ptZ 20 ilp-by this OK day of TIG by r i J g _ IILJ�S2 l Q el/1Q (Name of person acknowledging) (Name of person acknowledging i) ! o. I gn ture of Notary Public-Sibte of Florida) (Si ure of Notary Public-S to of Florida) \ Personally Known OR Produced Identificatio Personally Known OR Produced Identification T e o Identific tion Produced Type of Identification Produced Commission No. (Seal) Commission N LASHAHN ING AM -•'o�"av P`�B�'' NotaryPublic -State of Florida + ues e c . Revised 07/15/2014 LASNAHNAINGRoMlorida ,+ �o� MyCommissxp ++ +F 177249 public•State c 20 2018 i. �,��,�9ii,_ Bonded tm ,� �� �• `Jl3fy ASSn. '_• •.`' y Com FF 1772 i t w REVIEWS FRON Com Si #VISOR",,'_'`:PLANS �GETATION YSEATURTLE MANGROVE COUNT ;r9, F. fik%onded to •IEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE {. INITIALS I I