Loading...
HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: J 71 m�HM 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 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I Address: Legal Description: 4 14 AJ Ulu -r //- Property 1- Property Tax ID#: 13©l- Cle tg22— i50"-2, Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: LeftSide: OHVAC Ll Gas Tank 11 Electric 0 Plumbing Total Sq. Ft of Construction: Cost of Construction: $ _ N JCI nu—WMi.n mi oNPry. aasPi. - _Shutters ❑Windows/Doors Sprinklers 1:1 Generator Roof SFt. of First Floor: _ Utilities:i Sewer D Septic City: /:�/_ Piei-cam State: 2� Zip Code: .3Ei95I Fax: Phone No. 77Z- `x$05 - !/S97 E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Building Height: Name: ._�' t4w ✓tiux Company: NC LP(,c T %Ltsc G�4/)_ Address: ' ley k PL' �— City: 1 f2 Pim Sr:,--AtAE= State:L Zip Code: F2_,a9 GO Fax: -7'1 z 7(--9 S� Phone No. -7 7 a - S -Co E -Mail: State or County License: 6 C 0377 68 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION'LIEN LAW INFORMATION- FRONT DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: Not Applicable Address: MANGROVE Address: COUNTER City: Zip: Phone: State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: Name: _Not Applicable Address: Address: City: City: Zip: Phone: Zip: Phone: 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 wiHa uthorIze 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 exemptfrom 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 gnature of Owner/ Lessee/Agent STATE OF FLORIDA COUNTY OF 5 f STATE'OF FLORIDA COUNTY OF a o,ck- The forgoing Instrument was acknowledged before me The forgoing instrument was acknowledged before me this SChday of 7cc L / 20 y(- I thisl %day of :SVA-1�=J 20 1kp by JoAI'-- T. /3G)-e/r-h Som S - (Name of person acknowledging) (Name of person Notary POblrc- State Personally Known V Type of Identification Commission No. Revised 07/15/2014 OR Produced Identification RHODA M. JELMBY MY CO&"NgN 8 FF 106964 EXPIRES: July 26, 2018 Bonded Thru Notary Public Dnderaftra (Sighature of Nt Personally Know Type of Identific Commission No. Public -State OR Produced Identification Notary Putill $% of Florida My Comm. Expires Jun S. 2818 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Planning & Development Services Building & Code Regulation Division 2300 Virginia Ave Fort Pierce, FL 34982 772-462-1553 Fax 772-462-1578 ASBESTOS NOTICE TO CONTRACTOR Date: �I / Contractor Name: 73-A v 77-O L -km g y Business Name: f L6VlET ii©t. SE Ccs& f(5Af3 i LOA1 Address: 50Q-�) a�fti t�1�F�E City: Ucgc) State: -;'-L ZipCode: C9� Re: Job Address: 700? Thy% s'4 /-4Nt5F It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applic le in accordance with state and federal law. 1 Sign re & Date COUNTY; Planning & Development Services Building & Code Regulation Division 2300 Virginia Ave Fort Pierce, FL 34982 772-462-1553 Fax 772-462-1578 ASBESTOS NOTICE TO CONTRACTOR Date: �I / Contractor Name: 73-A v 77-O L -km g y Business Name: f L6VlET ii©t. SE Ccs& f(5Af3 i LOA1 Address: 50Q-�) a�fti t�1�F�E City: Ucgc) State: -;'-L ZipCode: C9� Re: Job Address: 700? Thy% s'4 /-4Nt5F It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applic le in accordance with state and federal law. 1 Sign re & Date