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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � ko Permit Number: I exp fr Y dpiE � �� t_,,�r Building Permit Application AUG m8. 1016 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: I PROPOSED INPROU ME T LOCATI'OaN} � ' Address: `� 7 Wl rq eg oc,, \ PW c Q F:L 34992- Legal 49 '2,Legal Descriptlion: 10+ 1+0 n U o C Al Nn f+ v f" e +q{�S U'4- I�CVI�I p Property Tax ID#: � ©�- 6 0O ' 0 0 3 0 0 0 - 3 Lot No. Site Plan Nam e: Block No. Project Name 0 Ind tiq { ;Ver 6+gine Setbacks Front Back: Right Side: -F'F Left Side: D'ETAILE{D ®E?SCRIPTION O 1/UORK:. - 51 r� � og r qn� to tqr j t pCiye w�� l 4' nc�, 'Fh�cUl , 1 5 00 ��6 tr Mesh I CONSTIOlin N INfORMAT�lO'N � inn Additional work to be pertormed under this permit-cnecK all Mat appy: _Mecha ical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers 7.Generator _Roof Total Sq. Ft of Construction: ® � if 0 Sq. Ft.of First Floor: Cost of Constiruction:$ j/ Utilities: _Sewer _Septic Building Height: 0: N"�E/L•SSE: � � �-_ � COR/� TOR{. _ Name NaW(tw Q onn o`( Name: Address:614 1 0 7 S k43 N fig, Qci;wQ Company: City: <Jof+ Qe r G Q State-�F�- Address: Zip Code: w�,34 $9- Fax: City: State: Phone No.(J 7 7 i` 14 0 - 8 3 Zip Code: Fax: E-Mail: r Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License LIf value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL C®NSTRU,CT1®N LIEN LA4W INFORII/IATI®.N 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: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. 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 thepermit 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. Sigriatu_rr'o Own'erLessee/Co tractor as Agent fol05r,`i Signature of Contractor/License Holder STATE OF FLORI oq ;m STATE OF FLORIDA COUNTY OF "~ COUNTY OF The fo ing instru nt was acknowledged,before �g The forgoing instrument was acknowledged before me this day of 20� by z m�m this day of ,20_ by Z '55 (Name of person acknowledging) 8�Q (Name of person acknowledging) N (Signature ofo ary Public-State of Flor a) / (Signature of Notary Public-State of Florida) Personally wn OR Produced Identification Personally Known OR Produced Identification Type of Identific tin Type of Identification Produced Produced Commission N U (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR, PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014