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HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /' I' / Permit Number: I Building Permit Application REC c Planning and Development Services JAN 0 6 207 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: c`l �Cr v T PRIOPOSE � INP'ROUEME'NT LO ATION: Address: /! 9F�:� X 11Vz)1,4/,/ 1�/� T��r_� .,. .Qc��cf� r X9-5'7 Legal Description: ® - J a Property Tax ID#: 7 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D ► DE�SC P 10 �F 0 _�E_L b n�99� ,c�l�,{ QL►//) /.-,dt2 4Z./C z� _�cCL COS UCT 0 FO' A I'ON: Additional work to be pertormed under this permit-checK all tat app y ✓Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 'VR(n • i7�' Utilities: —Sewer _Septic Building Height: O E E�S�S CION RAC OR: Name S;ezz Name: !;EZ 4gL Address: , ! /4Vn1.41V '4A Company: City: T��s�jr ,�,cAc11 State:,,--/- Address: 2 �..t� Zip Code: SV Fax: City: 'g!2'r L State: Phone No. Zip Code: Fax: E-Mail: Phone No :Z-7 x !/8_S'— 0 Zi(g5� Fill in fee simple Title Holder on next page (if different E-Mail Q 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©NSTRUCTI© LIEN LAW INF© MATION: 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 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. 'Ansi Signature of Owner/Lessee ontractor as Agen - ' ` - Signature of Contractor/License Holder �� o STATE OF FLORIDA JJ � o!I STATE OF FLORIDA JJ xa COUNTY OF eIG% x`> COUNTY OF � 2 mC70 9Er 1, The forgoing instru nt was acknowledged bef ME The forgoing ins ent was acknowledged before e, iv z this day of 20b w z= this day of 20 by mT (Name of person acknowledging) (Name of person acknowledging) Signature otary Public-State of fforida) Signature of tary Public-.State of Florida) Personally nownOR Produced Identification Personally KnGwn OR Produced Identification Type of Identificat' Type of Identifica i n Produced "=.J),_ L- Produced Commission N (Seal) Commission N (Seal) REVIEWS FRONT ZONING 'SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014