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HomeMy WebLinkAboutpermit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 a_:�A ^"�110 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) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: Legal Description: L01-y—c-_L_ Property Tax ID #: l._ �CCD5 ^ iQ�\-kQ CDO - C) Lot No. Site Plan Name: Block No. c L Project Name: Setbacks Front Back: Right Side HVAC 11 Electric Left Side: _ "Shutters ❑ Plumbing ❑ Sprinklers Generator Roof Roof pitch aWindows/Doors Total Sq. Ft of Construction: Sq. of First Floor: _ Cost of Construction: $ l��j� �� Utilities: Sewer 0 Septic Name-77rc��L �QN.S Address:�S�C]� �0�Z✓ City: State: Zip Code:Fax: Phone No. LA`©19 _ (Xi5l� E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Building Height: Name: ler �^1 \ Vr__ r Company:7�'�L) CC9-01ac, ``" Z c� PIS(. Address: ` -_-: �-� Ill r� rpt - PC City:State: EL Zip Code:Fax: q (p0-`7(, j Phone No. —1� - 4lo''O^_7 (6�D E -M a i I___T IN,—\i ((50C V' nr 'Y?Ai nP.Ck.Oc1'Cc[9� State or County License: k"i Com_] it value of construction is 5Z500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER Name: _ Address: City: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: State Address: City: State: Zip: Phone: Not Applicable I BONDING COMPANY: )✓Not Applicable Name: _ Address: City:_ Zip: I certify that no work or installation has commenced prior to the issuance of a permit. Phone: 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. s Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORI A STATE OF FLORIDA COUNTY OF S _ I. \_ c� .L COUNTY OF 3_- _ - The forgoing instrument was acknowledged before me Theforgoing instrument was acknowledged before me this � day of � 'cir c- 20 ��by this � day ofDCC cx<,\fJ=-<_, 20 `� by (Name of person acknowledging) (Name of person acknowledging ) (Signature of Notary Public- Slate of Florida ) Personally Known V OR Produced Identification Type of Identification Produced (Signature of Notary Public- StA of Florida ) Personally Known OR Produced Identification Type of Identification Produced Commission No. EE_Q ty---)C YpgY deal) Commission No. `�° % TIFFANY A. LEE MY COMMISSiOM It FF 101474 r IR April o,' �ry Bonded Thru Budget Nota ° TFOF Revised 07/15/2014 Fo�eLo. s Notary „eriices (Sea 4IFFANY A. LEE t MY COMMISSION # FF 101474 Bonded Thru Budget Notary Seivices REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS