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HomeMy WebLinkAboutBuilding Permit Application All APPLICAB b yMUS.T BE COMPLETED FOR APPLICATION TO BE ACCEPTED r ( 1 Date: Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division / 2300 Virginia Avenue,Fort Pierce FL 34982 J/ Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPtJSED 0,11 M§ tNMR-70TI I Address: + 3 rAL-w r INS 6&Lr-- - OwDW ISS -5y'F,` lyl5l0N Legal Description: Property Tax ID#: lr ©I r Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED Df�SCR+ PTt�N QF 1NORK: W%Ai, P6 EmC-rzic C IzcuiT F6p- H I N I-5PuT A& 5YST m Im C S E ZIO V4 Zoe AL PgVrr _ 4� 15iZ-0360 C®NSTRIJCTIQN I!NFORMAT ON: Additional wor to be pe orme under this permit-check all that appy: ethanical —Gas Tank _Gas Piping —Shutters _Windows/Doors i/ Electric Plumbin Sprinklers Generator Roof — — g — p — — Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ 350. Utilities: —Sewer —Septic Building Height: OUVNER/LEaS�SEE: CONTRACT(3R: Name 1JE(N IPrNA 6WWf6rV. . Name: HbME Eji�Lm(_ Address: N611C.I " mm Company: City: Fi: 1mr-- — State: FL- Address: 760% I"WCM KOAP Zip Code: . 'Fax: City: M State: Phone No. UM �+^916 I � 3 - R p�Zip Code: - 3'951 Fax: E-Mail: Phone No (77Z) 571- Z61 Fill in fee simple Title Holder on next page (if different E-Mail 9v5VAD I'15'-" YARao.coM from the Owner listed above) State or County License EL 13006-IZS If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SU'PPIEMENI'> L C®NSTRUCTIUN JELAW NFQRMATI�,®N: 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,vAqrk or rpcordi.nur Notice of Commencement. Signature of r/L ssee/Agent Signature V Vtra�ctor/License Holder STATE OF FLORIDA STATE OF FLORIDA S_� J �C COUNTY OF _�_��C— �� COUNTY OF [^ The for ing instrum was acknowledged before me The for oing instrument was acknowledged before me this l ay of 20 y this of 20 by (Name of person acknowledging (Name of person acknowledging) I (Signature of t _Public-State of Florida ) (� tr,, Nota Public-State of Florida) '' �� _t^* •n� Personally K` OR Pry a tification � y K►►g�wn OR Produced Identification LAW Type of]den f3c ti ;, ;IOtar} PubliJNGc-S HUFF L_�fiy(j„ „ len a� Produced ='F �o stare o1 Fl Prod.uceye���i�'�'• M eondeomm'Expire. FP3473pid` , `c ar� FFteOf Commission No. dthrou hNationa, )2o 19 Commission i�. vl ? (Seal) otary/IssIV a '�+ee �n ? �a ail, �?�119 Q REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.