HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INJO Mf[BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 '9 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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: i5c..44 o r.,6 0 I
Legal Description: gar.10r4
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION .OF WORK:
7ep Gl�y I &yci Va.r ; tO 1700 ' L' ),P —,Z. r
CONSTRUCTION INFORMATION
CONTRACTOR:
r.
.,v.
Name r
Address: _2J fit/. �� re w. --N.56 .
City. 'r State: jftj--
Zip Code: Fax: —
Phone No. (77,_Q 3(� — /��S
Additional work to beDe orme under tis permit —check
1]HVAC _I Gas Tank ❑Gas Piping
L
all
appy:
_ Shutters
a Windows/Doors
11 Electric ElPlumbingSprinklers
State: FL
I Generator
1:1 Roof Roof pitch
Total Sq. Ft of Construction:
. CO
SFt. of First Floor:
Cost of Construction: $ C21 00, 0 Q
Utilities:ln Sewer []Septic
Building Height:
OWN ER/i.ESSEE:
CONTRACTOR:
r.
.,v.
Name r
Address: _2J fit/. �� re w. --N.56 .
City. 'r State: jftj--
Zip Code: Fax: —
Phone No. (77,_Q 3(� — /��S
Name: �J0 Y, L®
Company: i-rcif C—Ovyregly
Address: !8'q s v
r
Ave -
vPZip
City: A;4 -s"�
Zip Code:_? Fax:
Phone No.
State: FL
E -Mail: —
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail:
. CO
State or County License:
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:'
DESIGNER/ENGINEER: _ Not Applicable
me:
ORTGAGE COMPANY: _ N pplicable
Ne:
Ad s:
Addre
City: Stat
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE H ER: of Applicable
Name:
BONDING COMPAN Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
Zip: Phone:
T
I ce that no work or installation has commenced prior�he issuancq/of a permit.
LucieCounty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
hich 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 recording your Notice of Commencement.
/,/,// � �Z �, - �_
FRONT
—
s
Sign re of Owner/Lessee/Contr for as Agent for Owner
Signatur of Contractor/License Holder
STATE OF FLORIDA% `
COUNTY OF 3� L %fir
STATE OF FLORIDA
COUNTY OF Lid CA
The f r oing instru gent was acknowledge efore me
this Jtlay of 20 Cby
The for oing instrument was acknowledged before me
this day of 20 L7 by
REVIEW
REVIEW
(Name of person acknowledging)
I, 1j, 9
(nzk nowledging )
__0 f r\
(Signa tu Public- State of Florida)
Public- State of Florida )
Personally Kr, Pwg CAgEpy um0dentific. tion
2=1OR Produced Identification
Type ofI' F}t� State of Florida
Type of Identi�R?bd
Cia
Commission # FF 234730
i• —«v`
Commissiori' o, Comm. Ex fres May($�a'��19
�uy•_
,. a�P •,
oin arANGELA M HUFF
Commission N; 2 ° « �; Notary Pu(t$alitate of Florida
Bonded through National Notary Assn. '
A; ti Y Commission # FF 234730
COMPLETE
My Comm. Ex i
Bonded through National Notary
Revised 07/15/2014
,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS