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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLf INFO LIST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1 r Date: 10k I 17 , Permit Number: J ` r( 117 "I'T ..__.__ Building Permit Application Planning and Development Services Building and Code Regulation Division '2300 Virginia Avenue,Fort Pierce FL 34982 t / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED INPROUEMENT LOCATION: Address: q! /u Ai-e-- Legal Description: Property Tax ID#: /G12 9 —7C» - /O 6 3 no n n Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAIL ��D MCR PT 0 OF WOR C CONSTRUCTI® IN O A ION. Additional work to be pertormed un er t is permit-check all that 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:$ ff-1Joe_4`04 Utilities: —Sewer —Septic Building.Height: 0 N E /A1@28S CO 0 R,TAMCNIKIRM Name &K-1 CoIVJe)`>7ltif_o /c fclA„i Name: Address: OV q-t 10 Company: y`T L £Le-Q-Tr en t City: C&nr-r S► LJ c-t-e. State:_ Address: i e m e, <r.J� ,-L_ &+JG Zip Code: btif 1$6 Fax: City: 1041`T- C-.YA l I10Lc°e_ State: �- Phone No. ��2- `� 8517 Zip Code: 13t1 9 t;3 Fax: E-Mail: ._ b-5 E6 Phone No _� t- N_S'2 -cOl I? Fill in fee simple Title Holder on next page(if different E-Mail S L7H •( from the Owner listed above) State or County License X;213 0 9 4 5�7 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUP ` L� �N CONSTRUCTI©N LIE LAW INFO ` MATItIN: 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 recordin your Notice of Commencement. r Signature of Owner/Lessee Contractor as Agent for Owner Signature of Contracto,/License Holder STATE OF FLORIDA ` e � STATE OF FLORIDA F COUNTY OF COUNTY OF The f oing instru ent was cknowledge�fore me The fP�ging instrum_ was acknowledge efore me this day of 20 1=(by this I `7 day of 201L/by WA S vn 4 (Name of person acknowled ing) (Name of person acknowledging) (Signature of Notar Pu lic-State of Florida) (S ure of No ry Public-State of Flori a) Personally Known OR Pr ed Identification Personally Known OR Produced Identification Type of Identification \� / _ Type of Identific i n� Produced , (� Produced L, _ Commission No. ANGEL-AFlo AFF 1 al�f cida Commission N i `•,PY�P�B,,, public to 234j3p otPaY P;a�,,, ANGELA M HUFF ,o�P i c,,, Notary. isslon#FF 2018 'r« «�: Notary Public-State of Florida « n•2 EXp«e Assn •97 ? Commission# FF 23 730 ;• . My Comm ati, '30— RVISOR PLANS VEGEtAtT N Mf ��fi•-F Vay.27.IC�TAt�J' ROVE REVIEWS 1 aCC7�'R,-,REVIEW REVIEW REVIEW REVIEW, ' t� �``�R' VIEW"�''�'�"'"^REVIEW DATE RECEIVED DATE COMPLETED ev.