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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `� ^ Date: Permit Number: a 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 endhL of line - PROPOSED Address: Lft 6 Om " Legal Description: Property Tax ID#: © �� r Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: (:'t Ys,� 110 DET/ ILED DESCRIPTIOWORKyt�' y e: 2 k , CONSTRUCTION INFORMATION „rs„sl ==�- F 1z.... .. .�:i1a T.F . itiona work to e orme un er this permit—check a _appy: ❑HVAC Shutters rs Windows/Doors ing ❑ ❑Electric I"J Plumbing ❑Sprinklers ❑Generator ❑Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor Cost of Construction:$ e�1c/,� Utilities: _Sewer❑Septic Building Height: i f fi OUlII��R/LESSEE °' CONTRA t,a ORS ,� ,t f a r t�r "aA_tl Name Name: e A7y: ress: t� `� Company: ) C tater Address Zip.ode—Fax: City: � State Phone No(Ji-(ALW Zip Code: 4-01 6) r E-Mail: Phone No. , Fill in fee simple Title Holder on next page(if different E-Mail: 0cx? from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required, I V SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION ,s L+ , 4 a , ,�'�r,C�a 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: 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 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 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 f Con ractor/Lic se HoMer STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF_ The forgoing instrument was acknowledged before me The fo oing in t was acknowledged before me this day of 20 _by this day o�_ A� 20/_J_by 1 I. s rl �t(�'• (Name of person acknowledging) (Nam f Orson acknowledging) U (Signature of Notary Public-State of Florida) i ry ub' -State of Florida) Personally Known OR Produced Identification ` n OR Produced Identification Type of Identification Produced Type of Identifications Produc LIBERTY A KING Commission No. (Seal) Commission No. =•; ._ �MISSION#EE877248 A RES:May 4,2017 i •�R�ti,,•• Banded Thru Notary Public Underwriters Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS I � I