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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ©ate: � h i I � '� Permit Number: _ Planning and Development Services Budding Permit Application Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34082 Phone: (772) 462-1553 Fax: (772) 462-1578 CommercialV/ PERMfT APPLICATlQ1V FC3R: To Select from dro box cli .. P ck arrow at the end of line Address: c4 a Legal Description: `� E t -P 0 , Property Tax 1 D 4: Site Plan Name: Project Name: Setbacks Front--. Back: fight Side; _. Left Side: Lot No. Block NO. 14 Gem 0 eat ell" ct t �'Z, s>n,/Qu U0 nuuruonal work to e e orme er Un 4t Es permit—c ec a UHVAC Gas �a app Y' Tank 0Gas Piping Shutters � gWindows/Doors Electric D Plumbing Sprinklers � Generator Total Sq. Ft of Construction: 0 Roof Cost of Construction: $- of S . Ft. of First Floor: Utilities:Sewer USeptic Building Height: vv � r j Name,/ Address: (.0 111 City:3' — - ,-� State: Zip Code.Ltq `j Fax: Phone No. 7�7';' E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name:Qi i J7G�e v - Company; - i�tii !C Address: l City:, State- � Zip Code:Sj Fax: 7��— Phone No. ------------- E-Mail: State or County License: 0 1 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 1I 010 DESIGNER/ENGINEER; __._ Not Applicable Name: Address: City: Zip: Phone: FEE SIMPLE TITLE MOLDER: Name: Address:. City: Zip: Phone: MORTGAGE COMPANY: Not Applicable Name: Address; State: City: State: Zip: Phone: Not Applicable BONDING COMPANY: Name: Address: City: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. Not Applicable 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, perforin 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 commencin r recordi ur Notice of Commencement---__ _ Signature of Owner/ Lessee/Agent ature of Cantractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF LkAo_ _ COUNTY OF Po r�UV LU CA e— The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this Il day of 20 ft�2by this—I( day of Zp by Did to (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- State of Florida ) Personally Known X OR Produced Identification Type of Identification Produced Commission No Revised 07/1 REVIEWS DATE COMPLETE INITIALS re of Notary Public- State of Florida Personally Known _X OR Produced Identification Type of Identification Produced esto-96C(Lot) Commission No. ..P , p 9 roz �Z BIN SaHidx� ate '° INDA MWO)BOUCHARD 9999Zl:IJ# NOISSEWWpOAW �_ �' My COMMISSION #FF125526 tIHVHDf10R 31UVW VaNl-1 o, ay 21, 2018 /2014— (407) 398-0153 FlaridallotaryService.com FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW