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HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICABLE INFO MUST.BECOMPLETED FOR,APPLICATION'TO BE-ACCEPTED Date: : Permit Number: l�P�.P 034 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 Address: r Legal Description: S1Q.')d-_bOI1CM2 Y1 11171-S COrh O Property Tax ID#: c sa&•(_Q©q• ()01q. (D0Cg Lot No. Site Plan Name: (� Block No. Project Name: Sao& 1)0110,r soms Setbacks Front Back: Right,Side: Left Side: ii 1611 oZ — PG I zoo S H (M 8 PGT( 22o R j q& C►M 13 a= PG i c,Qa� di rtiull MB Additional work toe e orme under this permit—check a appy: HVAC Ei Gas Tank E]Gas Piping _Shutters Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ f 3 62. Utilities:CnSewer'[]Septic Building Height: man=, Name ¢S a— Ir I'C I Dea Name: Address: 7ZO S. Onam fir. 3 lzi, C, Company: c7l City:. _QJI')sw cl, State:_FL Address: 1 Zip Code:3qq S'7 Fax: City: State. Phone No. _ �a aol9— 9�-�2 Zip Code: L g Fax: :Jy3— S �2 E-Mail: Phone No. g Fill in fee simple Title Holder on next page ( if different E-Mai `A from the Owner listed above) State or County License: (C Ll� If value'of construction is$2500 or more,a RECORDED Notice of Commencement is required. 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: 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 wo r In o Notice of Commencement. s _Signature of O er/Lessee/Agent Signature of Contractor/License Holder STATE OF FLOR A f STATE OF FLO I COUNTY OF c�'C,V 1 COUNTY OF�o Th Ling instr was acknowledge efore me The orgoing instrume t was acknowledged before me t day of 20 LW thizS day of 20 UL4 by (Name of person acknowledging) (Name of'person acknowledgingCV INC�A_ Jq L" ) Com-`_ (Signature of Notary P7nR State of londa) ( nature of Notary,Public-State of Florida ) Personally Known Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced /_ . 4' /� c Commission No.F`� �Z S g •.v,+ MY OMM SSIO Mssi No. 0 > (Seal) EXPIRES:Doc e ber 28,2016 Bonded Thru Notary ublic Underwriters 1ppY Py� Revised 07/15/2014 F ep; rs MY COMMISSION d EE 655825 ; '3= EXPIRES:December 28 2016 d h;; Bonded Thru Notary Public Undenwrilers REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE ✓ INITIALS