HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
70 Mm
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 f
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 1/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address; -t -rte V i
al Description:,` '-'. �. I
PropertyTax lD#:�� i� ' �Q�p Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all apply:
HVAC 0 Gas Tank ❑Gas Piping f _ Shutters Windows/Doors
11 Electric L'! J Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: S. of First Floor:
c)
Cost of Construction: $ (Utilities:Sewer Septic Building Height:
OWNER/LESSEE:
Address
State: f--2L-
Zip Code:Fax:
Phone No. 01_14) nK-2a — q t_n 7'D
E -Mail:
Fill in fee simple Title bolder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:
Company: PL_ ltji-L61 (Q e` SC-; t1 e
Address: i �k-CiY'% P-- _
City: prl llr a e State: L_
Zip Code: 3441 SQ Fax --1-73 -3M- ($Q
Phone No. -J _J;J -
E -Mail: C e_Aer. S�tUY\.k 61 111� I C4-_a(3i'Y\-CL'`
State or County License: CFC ( f 0_7�>
if value of construction is $2Sbb or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State: _
Zip: Phone:
FEE SIMPLE TITLE HOLDEN: Not Applicable
Name:
Address:
City:
Zip: Phone: _
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
State:
rNot Applicable
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 Horne 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 exemptfrom 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 Comme,ncPrnent.
Signature of Owner%Lessee/_QRifrractor as Agent for Owner
STATE OF FLORIDA �
COUNTY OF
The fining instrument was acknowledged before me
this S day of PvkQ_&f . 20 Irby
(Name of.person acln
(Signature of Notary, -_public- State of Florida )
Personally Known / OR Produced 1 'fication
Type ofi'aenalra IOr� rQ�e,�nnncn7osYFllfs4
132
Commis my COnnMISs�?R ss FF2336
xNlk�� l ay 21.204( eal}"
aon a�u� ss FlmdaNai_ce.coll
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
HATE
COMPLETE
INITIALS
Signature of Contractor/license Holder
STATE OF FLORIDA c.
COUNTY OF J" - L-
The forgoing instrument was acknowledged before me
this day of IU (19 , 20 1_'l by
State of Florida )
P!uducw-lgi �il7(tation
i•::1 ft AMt l&RAYVOND FITZPATRICK
'= F�'1iYC��aCUU®CCmeCmISSION * FF23302 I
xxpiArs Slav 21. 2Q %.1) !-
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW