HomeMy WebLinkAboutBuilding Permit ApplicationALL 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, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION.
Address: C I —ILES 9 L-A)
Legal Description:
Property Tax ID #: Lot No. A/%_3
Site Plan Name: Block No.
Project Name: 1'
Setbacks Front Back: Right Side: Left Side:
I_aETAILED DESCRIPTION OF WORK:
EMf�'Pw-"i Pa�-F. Far- (f0Q1&vcTiQrQ ,
[CONSTRUCTIONINFOWATION:
itiona wort to e e Orme under this permit- check a appy:
HVAC 3 Gas Tank ®Cas Piping _ Shutters L] Windows/Doors
lectric El Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ -- L;700 Utilities: -Sewer LJ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name L IitD
Address: 1131n1F, P,1) iai,W' (k.M h
C"sty: �.L'�N H �� 1 State: MA
Zip Code: CaL69 Fax:
Phone No. 7R- 90 `cam
Name: AlKTNUP, a(:,,r_L.MA-A
Company: ccv,^�tr6
Address: &INO-ITI
City: LOC16
Zip Code: 3 475 d
r c f ��r� N����e
R_
State: !=�
Fax:
E -Mail:
Phone No. 721-374 -57S�5
E -Mail: D0(k4J1Jc11 4 ! I-1 N67-
Er€rom
Fill in fee simple Title Holder on next page (i€ different
State 4r County License:
.Jf_C 000 307 Q,
fromthe Owner listed above)
it value or construction is �Z500 or more, a RECORDED Notice of Commencement is required.
NEER: ` Not Applicable.
Name: _
Address:
City:
Zip: Phone:
State:
MORTGAGE COMPANY: Not Applicable
Name: _
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY:
Name: Name:
Address: Address:
City
Zip:
Phone:.
City:
Zip: Phone:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated_
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 thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anti 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 pians, 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, wails, 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
commencimg work or rop'6rding your Notice of Commencement.
of Own0f/ Agent/ Lessee
Signature of
Holder
STATE OF FLORIDA tel' STATE OFIFLORIDA
COUNTY OF _ �5�"- �,... _ COUNTY CIF
The for ping instru ent w s knowledged before me
this day of 20�l by
7
(Name of p son ackno dging )
7
�4e�' 1,
{Signature of Notary Public- Stateof Florida }
i glNlilllily�
Personally Known . CR Prod``'0 OWyif
Type of Identification Produced�JQ .••`"•"• ���
i.Up �'oer2Z�o.o�:
Commission No. eal) 3 �;
#FF 9481%
REVIEWS FRONT I
COUNTER R LIC�is NkWIEW
RECEIVED
COMPLETED
The for Ding instru ent w s a nowledged before me
this day of c 2 ' Y by
(Name of person acknowl dging )
(Signature of Notary Public- State of Florida )
Personally Known OR ProducoI
Type of Identification roduced •;•••.
9 e Off` 2 �-�.c' "•
Commission No. ,"4eqer al�}
�r .. :-Z
PLANS IVEGETATION
REVIEW REVIEW
ACCURATE ELECTRICAL coNTRAcrpqG, ]NC.
7300 GULLOTTIMACE
PORT gr LUCIF, FL 34952
772,-$78-9171
CM 772-370-5755
FAX 878-2854
DCVR"CH@ATTXRT
[EmpogAky
i-50 AMPS ELECT,
METER W 1�o AMP
MAIN DISC & 150 AMP ETER
O.C.P.D, — ----I I a CTR
2' ROC
EMPTY CONDUIT
TO F.P.&L.
SERVICE FROM
TRANSFORMER
I # 4 TW CU IN 1/2'
TO COLD WATER PIPE
GROUND WIRE TIED TO STRUCT. T 1 -5/13 Rads
STEEL IN FOUNDATION,
GROUNDING ELECTRIC CONDUCTOR MUST BE
CONNECTED TO- OUTSIDE RE -BAR �' MIN NO
PLASTIC UNDER RE -BAR 20 FEET NEAREST OUTSIDE
[IF FOOTING NEC 250-52A (3)
ELECTFUCAL RISER N.T.S.