HomeMy WebLinkAboutBuilding Permit applicationS 1-Ut �f -'�
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
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
PERMIT APPLICATION FOR: To Select from dropbox, dick arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
(or L 17t -ldJ1Y/
Property Tax ID H: '3327- 5 -OZ - m/i9 -52'w -,S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Froni Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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5k Ft/ flea% .vy.�Hyo zs
Ak1 000&e/as
CONSTRUCTION INFORMATION:
AnOnlonal Work SO oe normen unve. I' u1 Penun—u.c" o.. rr9
I'SHVAC Gas Tank ❑Gas Piping _Shutters []Windows/Doors
L (Electric ❑ Plumbing ❑Sprinklers ❑ GeneratorL ( Roof Roof pitcn
Total Sq. Ft of Construction: 131Z Sq. Ft. of First Floor:
O
Cost of Construction: $ 27 3S ✓ ❑
Utilities: Sewer _Septic Building Height:
OWNER/LESSEE:
it
CONTRACTOR:
Nameke,'A4 Ql ro/rlln
Name: suc
Address: /yf R /%i. �o��/FiP�
Company: rat COd
rM.t
City: ,/iU14'git-r State: CT
Zip Code: 042/22 Fax:
Phone No. 772 P/2 5/.3 $�f
Address: p0,9DY 221E
City: PO4 Jr Lua:f Stater
Zip Code: 3iAff? FaOffl!K 3.39`/
Phone No. !ii y A7f 0%35/
E -Mail: P�iy//
�411%� 16mV,71
E -Mail:
Fill in fee simple Title Holder on next page[ if different
from the Owner listed above)
State or County License: t -4r
8/76/.S
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B value M construction is yL5uu or more, a ncc.vnuev rvvace o, wvvn................ w-=
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT ZONING
COUNTER REVIEW
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
DATE
Address:
City:
Zip: Phone:
State: _
City:
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER:
Name:
_Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
structure. Pleaslecconsult wthpyolur Home Owners Association ndion rreview your deed foaws or a i covenants
any restrictions whichimay applyhlbit such
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: roam 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
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF �-`T z Vu E COUNTY OF (Z 'T 6V GY F_
The forgoing instrument was acknowledged before me
this qday of .1 20 ]--by
Personally Known _ OR Produced Identification Y_
Type of Identification Produced D
G(10 7 THEODORE S
Commission No. 44 eap
Notary Public S
Commission
s1�die My coma,....,.
Revised ( 15/2014
The forgoing instrument '`
e,nvias a/s acknowledged before me
j
this day of � 20 12by
'It eo n%^e S 4r4h /s
(Name of person acknowledging) n /j
(Signature of Notary Public- State of Florida I
Persmally Known OR Produced Identification
b6ry Public - State at
Commission M GG Oa
REVIEWS
FRONT ZONING
COUNTER REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS