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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Annliratin� Planning and Development services Building and Code Regudotion Division 2300 Virginia Avenue, Fort Pierce FL 34.982 Phone: (772) 462-1553 Fax: (772) 4621578 Commercial Residential Y'✓ LPROPOSEDI RMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line lir�PROlEM1=1T To Address: Legal Description: C-ec (rG (mad �'a.--(t - { f� r f !, - (,�, [ (-.rt5 �•wtsl. z -�" Property Tax ID #: d - [([- (1 Q(So_ 'Y Lot f\fo._ ac Site Plan Name: Project Name:Block Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION (JF°WORK: l r1aIL e kc -tri G W FC r 6k u'f r` n - _ lrl�c� r23D/yI q CONSTRUC TIOUINFORMATIOW �( L=MVAC c, ,u1 ,1 reu Gas Tank unaer rnis permit - check a []Gas Piping app y: Shutters Electric �� jbl Plumbing Sprinklers I Windows/Doors 1-1 Generator Roof Total Sq. Ft of Construction: Cost of Construction: $ 5- 0 & OWNER/LESSEE: Narne_ ,rer ell f,; t -A S Ft. of First Floor: _ Utilities:M Sewer O Septic Address: 777 4 J_ �j ",,I { e.�ry_ City: qe- s f palvu bugiN Mate: L Zip Code:,30(66 Fax: Rhone No. E-Mail,- Fill -Mail;Fill in fee simple Title Holder on next page (if different from the Owner lister! above) CONTRACTOR: Name: -Tf)rQDh 'r"O Building Height: Company: G e 'i f RintbiftQ Address:AC1'� Sg so,+da ve,- City_ u ett State: I� Zip Code: mS-z _ Fax: -712-33 -abgo Phone No. 71-- 3(r,,� E -Mail: �erists {�i�rhb Se��d�c e fxi 0 State or County License: LA if value of construction is $250©or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL C NSTRi1CTIOl LIEN`fAW INFORMATION: Name: Address: City: Zip: Phone: IEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: ,WE State: Not Applicable MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Address: City: ZiP:. phone: Not Applicable State: Not Applicable I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Countyy 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 5t. 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 Cvrnmencement 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 work or recording our Notice of Commencement. Signature of Owner/ STATE OF FLORIDA, COUNTY OF <V t � C ": The forgoing instrument was acknowledged before me this _2 --day of 20 Eby (Name Personally Known ~ OR Produced Identification Commission No. (Sea€ Revised 07015/2014 REVIEWS FRONT ZONING SUPERVISOR -- COUNTER REVIEW REVIEW COMPLETE INITIALS of STATE OF FLORIDA _ COUNTY OF S"" Z The forgoing instrument was acknowledged before me this 12. day of �-4 a L 20 16 by 3Va�Fie Y erson cls�4rs�s7t� Personally Known } OR Produced Identaf€cation 770_i5 r;rcat'son Produced Commission No. (Seal) PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW