HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -
Date:��3��'� Permit Number:
RECEI117D MAY 31201'
Building Permit Application
Planning and Development Services
Building and Code Regulatiori Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)452-2578 Commercial Residential -
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
>PROPtJSED IMPROVEMENT LOCATION
Address: 6
Legal Description C a/ j� e
C�l h
Property Tax JD#• L , Lot No.
Site Plan Name: i'�d - �tfti j— O C30-,5 Block No.
:Project Name:
Setbacks Front Sack: RightSide: Left Side:
DETAILED DESCRIPTION,OF UVORK
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CONSTRUCTION INF(?RI�tIA - ON
.Additionalwork—to-Fie nerformed under this permit check a appy:
F1HVAC 1_3 Gas Tank -Gas Piping _Shutters n Windows/Doors
nElectric F�Plumbing OSprin6ers FIGenerator F]Roof
U y
Total Sq.Ft of Construction:_aCJ Q 4• r Sq.Ft.of First Floor:
Cost of Construction:$ Utilities: Sewer a Septic Building Height:
(3WNERf LESSEE CONTRACTOR:
Name e �` Name:-91& -
Address: cf J' Company: C c 7& C �k
City: Stater Address: ;�— t�c�c. P tom_ lie✓
Zip Code:� �f Fax: �C/ City: F f (Y(CPC-e, State: r--(,
Phone Na (ltd`` a�C rp Code:rl tf t`r' • Fax: ? "" �(v rFf
E-Mail:— Phone Na
Fill in fee simple fdle"older an next page(if different E-Mail: ce eC(A rea
from the Owner listed above) State or Coun 'cense:
ff value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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 withyour 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,screewrooms,.and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your-Gaying twice for
improvements to your prgperty.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
co_mmen ' work or recordin our otce of Commencement:
Si nature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE.OF FLORI A
COUNTY OF !9�'_ lry c COUNTY OF S .
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this'N\ day of 'Ma►:�' .-20 by this At\.day of M cky .20_ijh by
< �� 'C
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Publi -State of Florida) (Signature of Notary blit State of Florida)
Personally Known OR Produced Ice n Personal C@gt4d�e� �tloniType of Identification Produe Type of I n P�
NNN GG 022023 *i EXPI ES:D mbar W.20 20
Commission ,� ISSION �,`'�020 Commiss It r�i Imta publlcUnde ars
• ;*: ;peeem Undennaters
"s�• ;;:' endedThNNoteryPublic i � •
Revised 07/ 4 -
REVIEWS - FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INRIALS -