Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �'( � Permit Number: /6 0-6 0-_1? 09 I Irmo fign Building Permit Application RECEIVED Planning and Development Services Building and ICode Regulation Division JUN /g 1016 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ C PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IIVIPR0 EME`NT LOCATION W { Address: Itic)k -fee,tkier c'T-e-e -.Ir Ce Legal Description: Property Tax ID#: 12 r' 8'0 L D 2.()-0 (900 a' Lot No. q Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAlLEDDESCRIPTION_OF WORK.: (dQ t c4yld k"V-q-�q'U C�' a IG kq Z�oo r, CO,NSTRUfCTION FNFORMATIO.N Additional Work toe e orme under this permit-check a appy: HVAC Ei Gas Tank F]Gas Piping _Shutters �✓Windows/Doors F]Electric 1:1 Plumbing O Sprinklers E Generator F] Roof Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ �1 L/©O Utilities:Cn Sewer O Septic Building Height: OWNER/LESSEE: 'CONTRACTOR: L Name �£.y`L � �c2 `(� LA-ox 0V\' d1 Name: by-VIC�1In.Or (6G 0,5 R- (f ool- (Air 4k Address:, ' 0� 4P_"t tr Cr-e� k d Company: 6dowl, QeQ -e\P, eO city:. -Te IP l .e rc-e. State: Address: C1 2 k 9 LV W,elf 0 / 4-11P, Zip Code:3 Lf q.(,-Z Fax: City: } S{ L-9 ti 2 State: -e L Phone No. ,IS'^13 ^ �!$c(^ �(4 y z Zip Code: RWFax: E-Mail: Phone No, 7)r2 - Fill in fee simple Title Holder on next page(if different E-Mail: 00GuA �2('i.,Vi.2-3 79 ®,L C from the Owner listed above) State or County License: 2-]10% If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i SUPPLEMENTAL C0.NSTk'UCT10N LLEN'.1.AW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: I Phone: Zip: Phone: I FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: I Address: City: I City: Zip: Phone: Zip: Phone: I I certify that ri�o work or installation has commenced prior to the issuance of a permit. St.Lucie Count�yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in con'Flict 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, accessorystructures,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*st inspection. If you intend to obtain financing, consult with lender or an attorney before commencinp,work or recording our Notice of Commencement. s _Signature of Owner/Lessee/Age t Signature of Co rise Holder H STATE OF FLORIDA = rz C2 LL� STATE OF FLORI - W COUNTY OF g;L COUNTY OF =U_ JEU A �z� a The f agoing ns ent was acknowledge befo w 2 The for oing instr m nt was ac owledge befor , this da of 20 f�� b o E 2 'UJ ' y / y oa this day of 20 by z �YW C:) ~ o �W c t°�I CYl .. . . m _ m l e�� D co o.. (Name of person acknowledging) _ (Name of person acknowledging) (Signature ofNo ublic-State of Florida (Signature of tary Public-State of Flo lda) Personally Known OR N ed Iden ification Personally Known OI Pr ced Iden ificatlop) Type of Identification Produced r 1 Type of Identification Produced J/ Commission No. (Seal) Commission No. (Seal) _U_ Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS I