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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �' Permit Number: a RECFjVtSD Building Permit Application Planning and Development Services JAN 12 2017 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential i/ PERMIT APPLICATION FOR: P'R®POSED INP'ROWEMENT Cr Address: -1-104 r I � Legal Description: 4t4L- &a UZS 0r Property Tax ID#: t /-50 L 62 t2 2 b�OJD- Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED ►MMFHM ®' 0`Ra Sh0 oyer d CONSTRUCTIO lNF®R .ATION: AaMfional work to be pe Frorme un e t is permit-CA;&V tat appy: _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:$ ''ILDC�•00 Utilities: —Sewer —Septic Building Height: 0 NER% M1.00011 Name - Name: Address: r Le Company: �. City: 6i ler« State:� Address: Zip Code: Fax: City: State: Phone N ."77`I- ZIU.A GZ Zip Code: Fax: E-Mail: RIA&'I ' Phone No Fill in fee simple Title Holder on next page(if 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. SUPPLEM1EINS TAL C«©NSTR,UCTtONLI'E;NI LAW INF®R�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. you intend to obtain financing, consult with lender or an attorney before corrArnenpi nlg vvorIqr WAp"ling your Notice of Commencement. \ � IM YA n Jure ofOwrer/Lessee/ ontr ctor as Agent for Owner.4Wture of Contractor/License Holder STATE OF FLORID _ n TE OF FLORIDA COUNTY OF UNTY OF The forgoing Te- (Name as acknowledged before me =o forgoing instrument was acknowledged before me this , day 20�by � day of ,20_ by ¢O g 2 O ¢>V d m of person acknowledging) a �� me of person acknowledging) (Signature of N ry Public-State of Flori a) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification v/ Personally Known OR Produced Identification Type of Identi ' t n Type of Identification Produced Produced Commission N (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.