Loading...
HomeMy WebLinkAboutpermit application 4 ALL APPLICABLE INFO MUST BE COMPLETED FOR-APPLICATION TO BE ACCEPTED Date: L; `/ Permit Number: �(J ®'1 • ®� `� o ' 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-of the'end of line PROPOSED IMPROVEMENT LOCATION: , ' Address: ©, /�Ci� *I f G 2— Legal Legal Description:_- �7 y r rO a g r o J Property Tax ID#t Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left-Side: DETAILED DESCRIPTION OF.WO.RK: �O" =CONSCTIOWINEORMATION: Additional work toe e orme under this permit–check al that appy: HVAC E'Gas Tank E]Gas Piping ❑_Shutters Windows/Doors Electric El Plumbing Sprinklers 1:1 Generator .. E] Roof Total Sq. Ft of Construction: Sq.Ft.of First Floor:' Cost of Construction:$ 2/ d Utilities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: - Name SSL° Name: ti t ` Address: Sn7 G tr�'� �^ Company: -2GJ (,-)A. 6740 1-1 City: _- Pr State:State:�G Address: sI vv l s'7"' Zip Code: �) Y 5 1 Fax: City: fyq cy 4ew State:_61 Phone No. Zip Code: Z!F'Vax: E-Mail: Phone No. 2 y r Fill in fee simple Title Holder on next page(if different E-Mail: / from the Owner listed above) State or County Licenses! C O 15 7 75 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: 4 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 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 comm cing work or recording your Notice of Commencement. S _Signa ure of Owner/Lessee/Age t Signa re of Contractor/License H de STATE OF FLORIDA// STATE OF FLORIDA COUNTY OF %��/� COUNTY OF The forping instru as acknowledge fore me The oing instru nt as acknowledge fore me this day of 2�by thi/ day of 20� by (Name of person acknowledging) (Name of person acknowledging) (Signature o Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally KnownPersonally Known "" P Type of Identification o y Type of Identification Pod.4Gey �, CHESTER J.EDWARDS .4� 6•i• Notary Public-Stat@ di f`16(idd 2�� ;�•; Notary Public-State of Florida at)an#FF 181484 Commission No. Con(®LsaY n#FF 181480 Commission No. • Co ' ' ' % c' My Comm.Expires Dec 7,201'8 . 's11 �' My Comm.Expires Dec 7,2018 ������a�� Bondedthrouph National Notary Assn. mit d through National Notar Assn: °F` Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS S � v E W