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HomeMy WebLinkAboutBuilding Permit Application I Ad APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � Date: d o'U Permit Number: 0111111111111 I i Building Permit Application j 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 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the en'd of line PROPOSED IMPROVEMENT LOCATION: Address: 5�o 9", 1 (-(V 'F-r go--1 Legal Description: TP.P,r-fw .11_LVec 02-J�1 (JNI-�'-- D$- 3 dig. �( '� lI s ar 3-715- q Property Tax ID#: -3 40 " (® 9 " 0Sr?3 000- / Lot No. Site Plan Name: !QJ Block No. Project Name: 00i l�► oGl� /11S7r �/ ' © Setbacks Front Back:�Right Side: 3 r-r Left Side: F, 7-' DETAILED DESCRIPTION OF WORK: .Y- N S4-A-f 1 k3ove- I-roap ,-f©o[ Xete5s ed , 2- I f hi 6rzvi . ?et`iw 4kr or -Fro pQrf� -r"® a?- fi-ke-e - f o '?6r914- I; CONSTRUCTION INFORMATION: Additional work to be nertormed under this permit-check all=appy: i HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors I Electric Plumbing ❑Sprinklers Generator El Roof I' Total Sq. Ft of Construction: - S Ft. of First Floor: Cost of Construction:$ oZOC7D Utilities:0Sewer ElSelptic I' Building Height: OWNER/LESSEE: CONTRACTORil 3: Name I>'1�('-bll(��� 1--A-VA4(57 Name: gymeot i Address: 59 D ,'5� i A4M DCompany: City: i-'!- p I+PSC-P State:EL Address: Zip Code: 3 Lf9 9",a- Fax: City: State: Phone No. 777- a5 :3 9 3 Fr Zip Code: Fax: E-Mail: 5 C=V 9 b 11"IZ ISJ 49 I1-D I r M Phone No. Fill.in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I SUIPPLEMENTAL.CONSTRU,CTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: 'i _Not Applicable Name: Name: Address: Address: J City: State: City: I i. State: Zip: Phone: Zip: Phone: I- i i FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: h I, 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. h Ii The following building permit applications are exempt from undergoing a full concurrency review:lroom 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 your paying twice for impr rents to your property. A Notice of Commencement must be recorded and posted on the jobsite bef e t e first inspection. If you intend to obtain financing, consult with lender or an attorney before com en inia work or recordin your Notice of Commencement. I, I I I ! iI S _Signat re of Owner/Lessee/Agent Signature of Contractor/License!Holder I STATE OF FLORID STATE OF FLORIDA COUNTY OF COUNTY OF The for oing instr ment was acknowledged before me The forgoing instrument was a 11knowledged before me this day of 20%�. by this day of i, .20 by - (Name of person acknowledging) (Name of person acknowledgirig) (Signature of Notary Public-Stile of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known ORIProduced Identification Type of I entifi ation Produced Type of Identification Produced Commission No. (Seal) Commission No. j.1 (Seal) N LASHAHNAINGRAM Notary Public-State o on a Regi:`e 15/geqr4•Expires Dec 20,2018 Commission#FF 177249 'Ifoji,110' DUIJUUU tillUUyll MUM.1—.1y R V,� SNT FROZONING SUPERVISOR PLANS VEGETATION I SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW j'; REVIEW REVIEW DATE i COMPLETE INITIALS I ,i I