HomeMy WebLinkAbout1554_001AL.L APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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4 -1 -
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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
PERM IT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: � C"
11..
Legal Description: Sri\ .!r`7 �. Lk -( A' ' \ d
Property Tax ID #: \ ° L Lot No,
Site Plan Name: Block No.
Project Name-
Setbacks Front- Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
c c)CDAV'CA— (�
v c_-)YNW
CONSTRUCTION INFORMATION:
itio or to e e orme under t is permit —check a appy:
E []Gas PipinShutters Windows/Doors
HVAC Gas Tank
EI Electric E]Plumbing Sprinklers 12 Generator � Roof Roof pitch
Total Sq, Ft of Construction: SFt. of First Floor:
n
U Septic Building Height:
Cost of Construction: $ ` �Utilities:Cn Sewer
OWNER/LESSEE:
CONTRACTOR:
Name Name:
=
Address:t— �.G—' `J Company: �:-2�`S"I
_ _
City: State: EL Address:
Zip Code: Fax: CityStater
PhoneNo ( Zip Code: `l Fa0-s�I.-IQDT, -C-l���
E -Mail: ! Phone
Fill in fee simple Title Holder on next page ( if different E -Mail: _ Uf+tit V��
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:
Name:
Address;
City:
Zip; Phone:
FEE SIMPLE TITLE HOLDER
Name:
Address:
City= - —-----—�
Zip; Phone:
Not Applicable
State:
Not Applicable
MORTGAGE COMPANY:
Name;
Address:
City:
Zip: T Phone: ,
BONDING COMPANY:
Name:
Address:
City;
Zip: Phone;
I certify that no work or installation has commenced prior to the issuance of a permit.
T Not Applicable
State:
Not 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 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 recordingYour Notice of Commencement,
_Signature of Owner/�e Age t -� Signature of Contractor/,Licens older I/
STATE OF FLORl�A STATE OF FLORA
COUNTY OF rr COUNTY OF t- �✓ r�%L_r
The for ping Instr ent l°'a� 'ck iowtedged before me The for ping Instr merit was a knowledged before me
this day of 20''�I>y this,;day of ��'i� �, 20 lILa by
(Name of person acknowledging) (Name of person acknowledging )
(Signat4i+ , of'Notary Public- St'a'te of Florida )
Personally Known _C_--IOR Produced Identification
Type of Identification Produced
Commission NoTV M0()j':7
Revised 07/15/2014
(Signat of fVFary Public- State Florida )
Personally Known ---OR Produced Identification
Type of Identification Produced
JOYCE MICHAUD
MY C1MMI5510N
"u{jjd Bonded Thai Nolnryi'ub •: Undsrvmlers
ssion No. �
JOYCE MICHAUD
MY COMMISSION A FFL
Bonded Thru Nolnry Ribk
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
COMPLETE
INITIALS