HomeMy WebLinkAboutBUILDING PERMITALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential /
PERMIT APPLICATION FOR: Window/door B
PROPOSED IMPROVEMENT LOCATION:
Address: 6Cn3 DnW
Legal Description:
V77-X?.^/)
Property Tax ID #: -C>37?-D/y^-^
Site Plan Name:
Project Name: _MP
Setbacks Front
-
Mjh
Lot No. SS
Block No. %2l.
Back:Right Side:Left Side:
DETAILED DESCRIPTION OF WORK:
9.eiM>ve d]AJcl di/«r/c<7</ ^ec-fJo/UQ f cjaor yfiiA
A/eW DAQ 9''^ 7' </oor.
CONSTRUCTION INFORMATION:
Additional work 1^o be performed under this permit - check all that^Si
Gas TankHVAC
Electric B Plumbing
Total Sq. Ft of Construction:
Gas Piping
Sprinklers
Cost of Construction: $ 90(0. nn
Shutters
I _| Generator
Sq. Ft. of First Floor:
^ Windows/Doors
Roof Roof pitch
Utilities: L^ Sewer LJSeptic Building Height:
OWNER/LESSEE:
Name J~0(jy McQpee
Address: 6oOS 'TcuJj-el/O
City: P/ercA State: FL
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple fitle Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name:
Company: FxcjS.I'i/ar
Address:Pr/'K£_
City: -A?^f 5*7 UtO'e State: FC
Zip Code: Fax: 77.2 - -XSal^D
Phone No.
E-Mail: l^tO)fJI^€yce.[</a rrrvPAJsj-ttJxA/'r^AJ.
State or County License: _ CG2C\sai<ii/
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
hVi
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
|/ Not ApplicableDESIGNER/ENGINEER:
Name:
Address:
City:
Zip:Phon
Not Applicable
State:
e
-±
MORTGAGE COMPANY:
Name:
Address:
City:
Zip:Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip:Phone:
Not Applicable BONDING COMPANY:
Name;
Address:
City:
Zip:Phone:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 conflictiwith any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please cbnsult 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 your Notice of Commencement.
Signature of Owner/.^^see/g^tractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF ,5^. Zc^dT/'g
The forgoing instrument was acknowledged before methis 3? day of Au^US'r 20 ly by
Kti/w k.
Name of persor/makirf^statement
Personally Known v OR Produced Identification
Type of Identificapon
Produced
(Signature of N Public- State
Commission No.LO 'S ^Q3^°''.---^-fSeal) CHRYSTAL GOMEZ
. MY COMMISSION # FF 203322
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
FRONT
COUNTER
EXPIRES: February 24,201£
Bonded Thru Budget Notary Service:
ZONING
REVIEW
SUPERVISOR
REVIEW
Signature of Contf^i^br/Lic^^se Holder
STATE OF FLORIDA
COUNTY OF .-6^
The forgoing instrument was acknowledged before me
this "9/ day of . 20 /7 by
P. ^akf \osT£^
Name of persc^making statement
Personally Known \/ OR Produced Identification
Type of Identification
Produced
ry Public- Stat(Signature of Ns
Commission No.
CHRYSTAL GOMI
MY COMMISSION #Ff
EXPIRES: February 2
Bonded Tiiru Baiget Notar
2
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
(.522
)19
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