HomeMy WebLinkAboutBuilding Permit Application t
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: Permit Number:
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 ✓
PERMIT APPLICATION FOR: Mechanical
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PROPOSED IMPROVEMENT LOCATION:
Address: %00 ,� t Icon DIS 1103
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Legal Description: f5?91hress QnG�Ola'JiniUM
Property Tax ID#: -150z__ (oz-0— 00E�4_000—9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DET-Al LED;D.ESCRIPTION OF WORK..
Ae chaoj e arf- Z -, -terns )4L5eer -T S_0
:CONSTRUCTION INFORMATION `.µ' 3
Additionalworkto b e e orme ,. under this permit-check all appy:
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HVACGas Tank []Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 3 9 q& Utilities. _Sewer❑;Septic Building Height:
OWNERAESS,EE: `` CONTRACTOR:
Name se-rome V)r-) Name: CNchn"d �v^inson
Address: gi000 � OC(pn 7v- -W 1 10 Company: newice / ` (l riCa
City:7enSen State:F I� Address:,9-05 N W i ot'. _
Zip Code: q51 Fax: City: ft I.OII,IC��I"doJe, State: 1—I
Phone No.770--c;)29— -795 Zip Coder Fax:9`� -7�
E-Mail: Phone No. 6761-q19.-f UD
Fill in fee simple Title Holder on next page(if different E-Mail:L&rindweyv1CtCLm2YiCa.C(,17�
from the Owner listed above) State or County License: '(21)CO 1101'51
If value of construction is$2500 or more,a RECORDED Notice of Commencement is,frequired.
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SUPPLEMENTAL CONSTRUCTION LIENrtLAW IWORMATION:.
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:
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 insp ction. If you intend to obtain financing, consult withAnder or an;attorney before
commencing w, recording our Notice of Commencement. 2
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Sighature of e J e-ssee/Contractor as Agent for Owner lSigriature of C.gntracto`r/t��l'cer Holdei
STATE OF FL IDA STATE OFv/FLLOORI A
COUNTY OF J9'� W(VC1 COUNTY OF �f u
The far oing instr ent was a knowledged before me The forgoing instrument was acknowledged before me
thisa day of t�CInUCI✓t- 20 (!—by this ` ? day of 0ni-IO 20 0 by
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(N e p n ackno (Na a of p on ac o
Sheneka Hardy
it Notary Pub is-State of Florida z�PR IpGe� Sheneka Hardy
t, Co^i��ssion#GG 33870 ® NotaryPublic-StateofFlorida
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(Si na ur Notary Pu. li" r Florid IF-Ire Val
ota y P I s Floric��ires 9/27/2020
Pe sonally OR Produced Identification Pn OR Produced Identification
Type ification Produced Tcation 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