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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: i 1 � dt1 Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34952 gg Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITAPPLICATION FOR: �10 �� bwf)VU P ®PtOSED INPROUE ENT LOCATION: Address: U► U Legal Description: Property Tax ID#: Lot No. Site Plan Name: rr nn Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DEBT. ILED DE�SCRIPT O Of WOR 1 CJr�SL C006 CONST UCTION INFORMATI� Additional work to be pertormecl under this permit—check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric t/Plumbing _Sprinklers _Generator D _Roof Pitch Total Sq. Ft of Construction: S� Sq. Ft. of First Floor: Cost of Construction: $_ '� Utilities: —.Sewer _Septic Building Height: 0 NER/L�S�S �E. C©NTR CTO Nam Name: Address Compan City: 1�� State:-R Address: Zip Code: Fax: City: State: Phone No. – Qz oq Zip Code: Fax: E-Mai�b �; Phone No Fill in fee simple Title Holder on next page (i different E-Mail from the Owner.listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL C«0 RNT110, LIEN LAW INFORMATI©N: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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 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. im -rovements to your property. A Notice of Commencement must be recorded and posted on the jobsite b ore the first,in ectio f you intend to obtain financing, consult with lender or an attorney before co mencin work or cor. ' our Notice of Commencement. Signatur Wner/Le ee/Contra for gent for Owner Signature of Contractor/License Holder STATE OF FLO IDA STATE OF FLORIDA COUNTY OF \ COUNTY OF The f r oing inst ment was acknowledged before me The forgoing instrument was acknowledged before me this 20IG by this day of 20_ by S� (Name of person ac owle ging) (Name of person acknowledging) ak"��A At�\ �L J (Signature oftary Public-State of FI rida ) (Signature of Notary Public-State of Florida) Personally Know' _ Personally Known OR Produced Identification A GELA M HUFF T Type of Identi ic `r Hype of Identification Produced { '2" No ublic-State of Florida Produced f : FF 234730 My Comm.Expires May 27,2010. Commission No. (Seal) Commission No.'' g.-,nd-i+nroughNatAk6yAssn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED •,'; DATE COMPLETED Rev.