HomeMy WebLinkAboutBuilding Plans ALL APPLrrIC,^ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 t �, l
Date: LO Permit Number: L� ��`� O"t't"�j
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
;I
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: ��Q
Legal Descriptio r10-1 Q , 62 293 Z5 - 4 ED
Property Tax ID#: 442L e(r T - 004(o 00b-
Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED_DESCRIPTIOROF WORK: _
n6+cul 11e-v Shower v w ve— cLncl c[rQirl,' n shown.
h
CON STRUCTlON;,INFORMATION:.
Additionalwork to be nerforme un -rifills permit-check all t=apply:
HVAC Gas Tank ❑Gas Piping _Shutters Windows Doors
i
FlElectric 0 Plumbing Sprinklers Generator M-Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
rr��
Cost of Construction:$ d Utilities: _Sewer[-Septic Building Height:
.OWNER/LESSEE: CONTRACTOR:
Name Name: L-curri en
Addre ` I Company v m F
-"L- . 2q 99 SVS 13Car Paw Ire- i ure �
City: Sta e:_ Address
Zip Code: Fax: City:_PCI I r n 0 t tU State: 'r L
Phone No. Zip Code:349q] Fax:
E-Mail: Phone No. :7_q2 - 2l 5 - 5, 35-2-
Fill
352Fill in fee simple Title Holder on next page(if different E-Mail: JC Lt L1 e9 r r
from the Owner listed above) State or County.License:
If value of construction is.$2500 or more,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:
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, con ult with lender or an attorney before
comiyMncing work or recArdiog your Notice of Commencem
DAW "kzo s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF N-C\0, 1n COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this b day of 5y r\e, 20 U-by this day of 20 -by
(Name of person acknowledging) (Name of person acknowledging)
QD4/
(Signature of Notary Public-State of Florida) (� (Signatu a of Notary Public=State of Florida)
Personally Known OR Produced Identification " ` Personally Known OR Produced Identification_ .
Type of Identification Produced Type of Identification Produced
Commission No. �C a3�°O` MAUREEN P E�Rl7RNtissio No. ! s7.�•� 1 (Seal)
Notary Public-S ate of Florida
-'_'+ •= Commission F
rFOFF`O�°;' My Comm.Expires May 14,2019
Revised 07/15/2014 """" Bonded through National Notazy Assn.'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS