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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAEJLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Il I—6— Permit Number: a- d� =jRECEIVED OCT 1 206 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 1.,-'0' Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line L - "'3r L-r {��J�}� �1/ 'riY.`. /► {�,*r `. �«- #:4-a fix`. �� sM: .r -. l'"a a1 Y `r S ti`3 ` _-- s �'3.�i+£:"�'.. Address: //// YL-IJ,� '�� _ Legal escription: ,�O akt�//3— — Property Tax 1D 1 L���—� , f Lot No. Site Plan Name: .<J� /� Block No. Project Name:_ 1�� cs E l�U Setbacks Front Back: Right Side: Left Side: �DRI1I=© DESCfiIl£ l�l OFt1fC?RK x G � � 4 2011 v f OJYJllfitl�e�21VM -k) r4 > Additional wor to b rme under tis permit—check a appy: HVAC M Gas Tank as Piping _Shutters Windows/Doors Electric ElPlumbing FSprinklers ❑Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor. Cost of Construction:$ t C�t.CJ C/� Utilities:OSewer Septic Building.Height: Name Name, li Address: Company: City: State: Address: L1 l Zip Code: Fax: City: State: Phone No. �/ Zip Code: fax: E-Mail: Phone Nq. Fill in fee simple Title Holder on next page(if different from the owner listed above) State or County License: 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 TITLEHOLDER: _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 priorto 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 fir s If you intend to obtain financing,consult with.lender or an attorney before commen ' co ding your Notice of Commencement. s atureof0u r/Lessee/Contractor as Agent for Owner atureofCo a or/LcenseHolder STATE OF FLORIDA STATE OF FLORID ,4 OF -6�-_ L e %_R11 COUNTY OF S� The forgoing, stru t as acknowledge efore me The forgoing instrument was acknowledged before me this\\ of 20 X\0 by this--\) day of 0 c� .20)k—by ame of o knowledging) (Name of person acknowledging) (Signature of Notary Publidjtate of Florida) (Signature of Notary P,,hlit4State of Florida) Personally Known OR Prd ced Identification Personally Known ORP uced Identification Type of Identification Produced TL �J Type of Identification Produc IEB­S— E�NMMMRIE GIVENS as�-cf DEMNNA Commission No. D MN#GG 022023 Commission No. L�� � MYC ION#GG 022023 MY cl tuber 16,2020 .� aP RES- COMI 15,2020 *; EXPIRES'Deco Unden+tilers Thni NotIn Public Underw tens Publlc '.; ...�o?� Bonded Revised 07/15/2 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS !'• �l�'�'•' ' � .•1 . .. l ) � � .. �\ t �i � � ... . t � i . I"� � �I.