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HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC BLEE�INFO MUST BE COMPLETED FOR APPLICATIO TO BE ACCEPTED p� Date: ry�v •J �P Permit Number: -- _� RECEI�,�rD Building Permit*Appi&tion Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 v/ Phone: (71 2)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbo , click arrow at the end of line PROPOSED IMPROU,EMENT LOCATION `:`jt x. T Address: LL Legal Description: PropertyTax ID#: �� r - ©(J O C3'" Lot No.�_ Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: I DETAILED DESCRIPTION OFuWORK r <{ s .d „ $�, � ;n , � s' R ���.� ���� �� �� � s 1 , � , CONSTRUCTION INFORMATION 4 ;. M ; >< Additional work to e e Orme urider this permit-check a appy: HVAC n Gas Tank E]Gas Piping _Shutters ❑Windows/Doors &Electr c 0 Plumbing Sprinklers _Generator E]Roof Roof pitch Total Sq.Ft If Construction: S .Ft.of First Floor: Cost of Construction:$ utilities: Sewer Septic Building Height: 01N�VER/LESSEE k,' C NTRACTOR r ' ` Name \ ctc1 Name' r�G eL) Address: �3 ® �J1 1 C A Cl,/" Company: C c,,S Ci l ec-�-t-t c City: i J r Stater Address: ')2( ke, I'✓c%l Zip Code: J? GI L-t 1 Fax: City: r o f9 ch State:-r-/ Phone No. /-A(.90 „2<Lf 7 Zip Code: 9A96[( Fax: S-69 - E-Mail• Ph ne Nom� `` = Y '? Fill in fee simple Title Holder on next page(if different E-Mail: l 6t6f be_cA iC Lk YW1G` from the ov ner listed above) State or County License: 6-U00-a. ?C1 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTA!CONSTRUCTION;LIEN LAW INFO NlATlO;N DESIGNER/ENGINEER: Not Applicable ORTGAGE COMPANY: Not Applicable Name: I N me: Address: A dress: City: State: Ci y: State: Zip: I Phone: Zi Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable B, NDING COMPANY: Not Applicable Name: N me: Address: A dress: City: i C( Zip: t Phone: Zi Phone: I I certify that;o work or installation has commenced prior to the issua ce of a permit. St.Lucie County makes no representation that is granting a permit will uthorize 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 Horne Owners Association and revi w your deed for any restrictions which may apply. In consideration of the granting of this requested permit,l do hereby a ree that I will,in all respects,perform the work in accordance with the approved pians,the Florida Building Codes and t.Lucie County Amendments. The following building permit applications are exempt from undergoin a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen roo s and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Co mencement may result in your paying twice for improvements to your property.A Notice of Commenceme t 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 commencingwork or recordingour Notice of Commence ent. Signature of owner/Lessee/Contractor as Agent for Owner Sign ture of Contractor/License Holder STATE OF FLIna STA E OF FLOR{ A COUNTY OF LilC�� CO NTYOF S`r' L--UCZl?, I The for ting instru ent was acknowledg tl„before me The f rgoing instrument was acknowledged before me this day If Z _. 20311aa by thi day of_"SIt 20 by (Name of persoi acknowledging) {Nam of person acknowledging) (Signature of Notary Pu -State of Florida} (Sign ture of Notary Pub14--State of Florida) Personally Known OR Produced Id.ntificatio Perso ally Known OR Produced Identification Type of Identification Produced Type f Identification Produced_'o'L- , 8 APs"` 07023 �C ' t #x'022 0 Commission No: �S��w 0���6.2p20.tecs Com fission No. �I � M1A�55 m`o� Vnde�` ?�'•°'uo`•'r-'- MY�1R�S:���b11c��er�n Revised 07/115/2 ��� •,,Q= I '' tee" REVIEWS FRO f�`FZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIE I REVIEW REVIEW REVIEW DATE COMPLETE INITIALS