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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �"' -� / Permit Number: RECEIVED Building Permit Application JAN 13 2017 Planning and Development Services Building and Code Regulation Division PERN11TTING 2300 Vrginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL 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: 3S--70 IJ- A --i- FL_ 3 -1 9 � Legal Description: ✓ �SCu S %/�� Stf� Ccn De,al/ mo/n 45S0G- :rAIC Property Tax I D#: 141Z-3 00 ©©®^ Lot No. Site Plan Name: Block No. Project Name: is Setbacks Front Back: Right Side: Left Side: lap/, lr_7vr �Mili I nil iMMI i Acid i lona wor to e e orme under this perm -check all that appy: i HVAC Gas Tank ❑Gas Piping Shutters Q Windows/DoorsVN !: i Electric Q Plumbing ❑Sprinklers Generator Roof i Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ c�3`y Utilities: `Sewer F-Septic Building Height: Name 14S Cu S 57jF,+ Ccs c Name: ,7� M Address: MI I I 5r �ElJE'AZ�L/�yi,Fl. Company: City: 5-7-meri— Stater Address: p � I Zip Code:3 `1�`'? `� Fax: City: /f� �/. �U�'�= Stater Phone No. 7?Z—q(01- 5_3Z0 Zip Code:3 Y 9 eta Fax:-777.,?,Yo-7117 E-Mail: Phone No. -772' Y®" 7el"2_Y` Fill in fee simple Title Holder on next page{if different E-Mail:_ �✓�/ ey- e��� L®_ 6041 from the Owner listed above) State or County License: 7 O 0✓�q j 6C Z 7 6Z If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. r. I; --------- .... - - ._.._ i- 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: 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 wor or recordinglyour Notice of Commencement. St. _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF COUNTY OF ORIDAj, s COUNTY OFSTATE OF ORIDA [1U i The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before meI. this / day of Xg4)U/4!''4 20 by this 113 day of J A/►U4r:X 20 LT by ! i (Name of perso acknowledging) (Name of person ckn ledging) ature of Notary Pub" -State of Florida) nature of Notary Publi State of Florida) I: Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatiob Produced Type of Identificati n Produced q;, T(AI)L WARNER Commission No. :':��"''.� TO&F.I}�(ARN1�R Commission No. :�'' MY COMMISSION#FF909394 MY COMMISSION#FF909394 '-;�. :° . October 11,2019 7)398-0153 FlohdallotarySerAw.com (407)98 0 53 Florldallom seNke.00m Revised 07/15/201 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE ! COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE ! COMPLETE INITIALS