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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 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) 452-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSE© INIPROVEMEINT LOCATION: Address: `11k Legal Description: Property Tax lD # — Site Plan Name: Lot No. Project Name: Block No. Setbacks Front Back: Right Side. Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION itiona wor to ferorrne un ert �spermit-c ee a appy: ®HVAC Gas Tank [—]Gas Piping Shutters 11 Electric EiPlumbing 05prinkiers Generator Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ Utilities:0Sewer ❑Septic OWN ER%LESSEE: CONTRACTOR; Name Name7' : Address Company: Windows/ Doors Roof Q Roof pitch Building Height: Zip Code: "Fax: City. Stater Phone No. Zip Code: Fax: E -Mail: Phone No. } Fill in fee simple Title Holder on next page ( if different E -Mail: from the Owner fisted above) State or County License: j1 If vafue of Construction is $2500 or more, a RECORDED Notice of Commencement is required SUPPLEMENTAL, CONSTRUCTION LIEN LAW iNFI�RMATIONs — DESIGNER/ENGINEER.: blot Applicable Name: MORTGAGE COMPANY: Not Applicable Address: Name: City: Address: State: City: State: Zip: Phane: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONI3ING COMPANY: Name: " ` —Not Applicable Address. Name: City: Address: Zip: __ Phone: City:_ Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. kes no which is inrcont€ictaw"ith any applicable iHo eaOrwn, granting Association irules bylawwill s or ande the pcovenantds that build the restrict subject bit 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 accessary 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. __7 as Agent for Owner STATE OF FL COUNTY OF The forgoing ins rument was acknowledg d before me this,) day of _ �s 20by (game of person (Signatur Notary Public- State of Florida } rsonally Known ORP duced identification d Type of Identification Produce., 4 Commission No. Revised 07/15/2014 STATE OF FLO A STATE OF The forgoing instrument was acknowledgeq before me th i day of 20 by person acknowledging) (Signature of N ry Public- state of lorida ) Perso y Known OR Produced iden E i Ty of Identification Produced J Commission No. *d'TR EYE A REVIEWS FRONT 'ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE _ __ COUNTER REVIEW REVIEW REVIEW REVIEW -AkfE REVIEW REVIEW COMPLETE INITIALS