Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: I Ot/�QO 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 PROPOSED IMPROV ENT LOCATION N A Address: 4( Y-1 rce //,` Legal Description: — �{ kZ4 P, (a t2C5'P-1-73S Property Tax ID#: I�Cj( — (�UeJ - �5� -�� Lot No. r'? Site Plan Name: n- Block No.42 Project Name: C� Setbacks Front Back: Right Side: Left Side: DETAILED:ESCR1PTION 4 1�. 11 -. v-ve e-*_1S4%vJ Qe Se(�' 03ktad uv\be((6iq v"nAcid -F new 51�-� S• � 3��a C©�STRt �� iNF�RM 1 itiona I work to . orme under this permit-check a appy: 11HVAC Gas Tank as PipingShutters Windows/Doors OElectric Plumbing S []Generatorprinklers Roof Total Sq. Ft of Construction: 3S Sq. Ft. of First Floor: f Cost of Construction: $ /$(1� ,p0 Utilities: OSewer OSeptic Building Height: Lf� �RLES$EE . . . CONTRACTOR. . Name Lbin Name: Address: -7q& 1 Company: h City: F-f PU rU State-EL Address: r' Zip Code: ;5�IQS1 Fax: City: 'J:L d1-f State: Ftp Phone No. Zip Code: ,q1 Fax:-77&-?,P8-7 -7?&3 E-Mail: Phone No. 7 11) o�g7 S��( Fill in fee simple Title Holder on next page(if different E-Mail: he- by—SI a-) Code✓e(I✓U&k Cb/Yf from the Owner listed above) State or County License: CCC 1300 57y If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTALCQNSTRUCTIQ(V LIEN,LAW, INFORMATIO 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 work or recording our Notice of Commencement. x S _S'5 Owner/Lessee/Agent Sig ture of Col o actor/License Holder STATE OF FLORIDA//q STATE OF FLORIDA COUNTY OF /v[Q(�- 7r) COUNTY OF A&C(,i4VI The forgoing instru ent was acknowledged Pefore me The forgoing instrument was acknowledged before me this,27 day of 20 LUby this_day of f 20 (a by (Name of person acknowledging) (Name of pers n acknowledging) (Signatu of Notary Public-State of tori a) (Signat re of Notary Public-St)to o F rida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced EL.—D. L Type of Identification Produced Commission No. F ��I�N IS (Seal) Commission No. l3 U S (Seal) ,,x"" CA 11111IM11111" Revised(T ,{,�}5/20�417?��N•'� v��M11 IONS,CO y zoF• 871345 REVIEWS �•F IN . QaVING SUPERVISOR PLANS VEGETATION S�70�T�/fat'15 `W i GROVE �' J F VIEW REVIEW REVIEW REVIEW DATE hrunmu���� .��%�-A. ..... .P� COMPLETE INITIALS