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HomeMy WebLinkAboutBuilding Permit Application ii. ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �Cil)1 I� 1�I I Permit Number: I�( � IIJ6-T.� caa. i 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 ZS PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED.IMPROVEM.ENT LOCATION l Address: V_ VU, 341 V 2- Legal Legal Description: n Property Tax ID#: 3`-102" w0 - ©?A " Lel o - C'I Lot No. _ Site Plan Name: ,� Block No. 'v Project Name: l ld,,ad Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF'WORK: save Yb� -k,,o e y o,,\ to codes , 1 v.�,'� ► � r Y IPA 16 ��I Z Ca Ptrr-Tvw�•be.�;vim, ►J4 ��--�p22.'? CONSTRUCTION INFORMATION: Additional work toInGasTank orme under t -checkispermit a appy: HVAC Gas Piping _Shutters indows/Doors Electric Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ �� Utilities:11 SewerSeptic Building Height:[] 5 � O1NN�ER/LESSEE: CONTRACTOR'; Name Q Name: Address: !iM(p '�E'�� Dc Company: City: _" State: Address:_0- 51S lS `�k S'' l 4 Z Zip Code:"3'4 Fax: City: \J U-T eeL,I0; State: Phone No.172 &7S Zip Code: 3ZJqy9•1 Fax: E-Mail: PhoneNo.� Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: CCC 133OCI�� If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. ' SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION !i DESIGNER/ENGINEER: _ of 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 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.ANotice of Commencement must be recorded and posted on the jobsite before the first inspection. If ou intend to obtain financing,consult wit lender,or an,attorney before commencin ork or rec rd' our Notice of Commencement. s _Signature caner/Less-eze/Adent Signature of Con ra or/Lice se Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF lsLe The forgoing instr ment was acknowledged before me The forgoing instrument was acknowledged before me this L day of�OU^\ 20) —by this J�day of �CUA 20 by l� (Name of person acknowle( ONIA DESTAFNEW ame of person acknowle ............. Q° MY COMMISSION#FF125 0 MY COMMISSION#FF125420 EXPIRES May 21, 2018 ov ,,.• EXPIRES May 21, 20 8 dr„* „ (407)398-0153 Florida L40?)d®n•C1a3 FlorldallotaryseNlce.com ature of Notary /lic-State of Florida) nature of ota P lic-State of Florida) Personally Known ✓ OR Produced Identification Personally Known'.'�OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. (Seal) Commission No. (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS