HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z',l l2.27 Permit Number:
Building Permit Application MAY p �01y
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 J(
PERMIT APPLICATION FOR: To Select from dropbox, click here
R.ROYPOSED iNPR.01/EIVIENTr LOCATION
Address: 7��0� / �1���./!/L�C � T& Z C1C rZ-
Legal Description: T � JORCsEW8_A7-S!l V�Ni7 d4ALk 41 LQ 7' 7
Property Tax ID#: 3%ZC- l0 'Vw 4 Lot No. 62r7
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETALLED D'ESCRIPTIO`N OF K""
1.4
IlT4 . 6 RAY I "A A-A.C41/
CONSTRUCTION INFORMATION
Additional work to be De orme under tis permit-c ec a appy:
HVAC F Gas Tank
-]Gas Piping _Shutters 0 Windows/Doors
FlElectric 0 Plumbing Sprinklers a Generator Roof
Total Sq. Ft of Construction: c2,3c r S . Ft.of First Floor:
Cost of Construction:$ Utilities: Sewer Septic . Building Height:
1190
OWNER/LESSEE _
CONTRACTOR
Name Le TMName: 1-1 `
Addre M Company• 1AJ& /1X7_ /IU A)d,
City: �Wzraff_. Luh 1C State:_r L' Address: 1&,91 SE&UTH ME
Zip Code: '? Fax: City: QTc r State:
Phone No.ld- -a&3-3?oS- Zip Code: oA Fax: 33�
E-Mail: Phone No. d
Fill in fee simple Title Holder on next page(if different E-Mail: I-Istmew6oC�Cl,1'
from the Owner listed above) State or County License: oZ
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
i.'
SUPPLEMENTAL CONSTRUCTION L[EN..LAW INFORMATION:"',
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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
7,�_s
S' nature of Ow essee/Agent gnature of Contractor Cicen older
STATE OF FLORIDA STATE OF FLORIDA p
COUNTY OF �'T LGr�I COUNTY OF
The forgo' instrument w acknowled e before me The fir ing instrument was acknowledged before me
this 1 ay of 20 �by thisf fday of //1fty 20 j7 by
sy7�-ue y uppse , -rte 6 AA)
(Name o person acknowled ' (Name of person acknowledgin
40"1
(Signature of Nota ublic-State of Florida ) (Signature of Notary lic-State of Florida)
Personally Known OR Pro uced Ide tific t' n Personally Known OR Produced Identification
Type of Identification Produced ./) Type of Identification Produced
Commissio 6,, oserrpstateol(�i6 Commission No. 4P ;}�j� orida
Kirnla J Simone yP� {(I�Yila J Srnone
My ion FF 981331 sion FF 981331
or expires 05118/2020 F Expires 05!14!2020
Revised o�f� t
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS