HomeMy WebLinkAboutBuilding Permit Application FROM :cast electric
FAX N0. :7725699775 apr. 30 2017 6:31PM P3
ALL APPLICABLE INFO MUST BE COMPLETt!)FOR APPLICATION TO BE ACCEPTED
Date' Permit Number:
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Building Permit Application
Planning and Vevelopment Services
building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 94982
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: �^
Legal Description;
Property Tax ID#: f ZCQ S-0 .- oat" (Ca —000 — C' Lot No..;, f
Site Pian Name: Block No.
Project Name;
Setbacks Front Back: Right Side: Left Side:
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- Additional work to b9i)ertormed under rs permit--chec a apply;
QHVAC - Cas Tank Gas Piping Shutters 0 Windows/Doors
zectric LJ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: Sq.fit.of first Floor:
Cost of Construction:$ �,� ---- Utilities:i._..i Sewer[]Septic Building Height:
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Nam 4, Name:
Address: l2g el 4/61,cwn In company- CAL
City: KC& Stater Address; �t.�r,- ;,,Cl --
Zip Code: �-t;� �L Fax: City:-- — !fir ' State:`!
Phone No. ��+.=rS,�1,;�,., Zip Code: 4: k Fax: 7„Z C �=►- ??7
E-Mari: Phone No. {y,,e
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or county license:
if value of construction Is 0500 or mom,a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL,CONSTRUCTION LIEN LAW INFORMATION.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY:; Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:''i11
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 inspection. If you intend to obtain financing, consult with lender or,an attorney before
commencing work or recording our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor License Holder
STATE OF FLORID _. STATE OF FLORIDA
COUNTY OF <I.czt �> COUNTYOFL.a�� -a
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this bli day of I'Y�n+,, . 20 -aby this /-9, day of 20 k by
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(Name rson acknowledging) (Name of person acknowledging')
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( natu e o otary Public-State of rida) 0 ure of Notary Public Sta Florida)
Personally Known OR Produced identification Personally Known OR Produced Identification
Type of identification Produced Type of Identification,Produced
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REVIEWS FRONT ZONING UPER - PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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