HomeMy WebLinkAboutBuilding Permit Application i
,AIL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t 1'
Date: Permit Number:
o
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 A9 r i Gtr l �°►+��
Phone.(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of;fine
PROPOSED IMPROVEMENT LOCATION:
Address: Pull- zVL DAA A r+C,r..Dstnrte;f sik �'rs�
Legal Description: seG�Hon I S j i own35S 13q E f 8 3$ -----7 Ne 11y 01� A!IG 11q - J_6-5Y
Lg1P FTk/L) (of.3905-ayg_7
Property Tax I D#: `O�Jl$ -I))- bbda -0D0_7 Lot No.
Site Plan Name: Block No.
Project Name: ��� M�rGtnda I-A rrY+ j
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Build 350A-rnp Ser✓+ee(EPech�ca)� l�r �zctu►'e Qole bar» �QncJ ' ?�}eisf,'n Shed
l rri e: �u,-� ur�,p ;s},'n Pole owner needs power d roPPedl i ��D his
gle. where W� iAre ;mpUln�`n�sC'r�;
CONSTRUCTION INFORMATION: I ;l
AddittonalwOrktobenertormed un er is perm -c ec a app .
as Piping _Shutters �" i Windows/Doors
{�IHVAC Gas Tank ❑G
ZElectric ®Plumbing Sprinklers F Generator Roof Roof pitch
Total Sq. Ft of Construction: S of First Floor:
Cost of Construction:$ y15o°° Utilities-I]Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:, 1
Name rrOtge Name: ;Tose. h 6. Nernion a Si,,
Address: Company:woes!L)&G ric 1,U(A'e_ N* Ine-
city: State:Z:�I_ Address- )Z o t, Ge l i 4 iA P i�e
Zip Code: :a:i-9S- o Fax: City: hn i- Aelee� State:f l-
b
Phone'lala� 71.2 P.2-o' ;PYl 1 Zip Code: 311982 Fax: IV Il4
E-Mail: os Z;Z-2 0 ��oo . Cd wi Phone No. -77; LI loS•.:2 to.3�
Fill In fee simple Title bolder on next page(if different E-Mail: ]QfSelgcS/)uc%ieC, �o).C Dtn -
from the Owner listed above) State or County License: EC IJ0012 a3
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. ,
1
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DESIGNER/ENGINEER: ✓Not Applicable` MORTGAGE COMPANY: Not Applicable
, Name: Name:
Address: Address: ! !Ill I
City: State: City: I IMI, I State:
Zip: Phone: Zip: I Phone`: I
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ,,-Not Applicable
Name: Name:
Address: Address:•
City: City:
Zip: Phone: Zip: IPhone'I !
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucia County makes no representation that is granting a permit will authorizethe permit holder to build the subject structure
which is in con�tliict with any applicable Home Owners.Association rules,bylaws or and covenants that diay restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any rest4dctions which may apply.
In consideration of the granting of this requested permit,l do hereby agree that I will,i all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St,Lucie County Amendments. 'I
The following building permit applications are exempt from undergoing a full concurrency revi Iw: room, additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses toianother 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 pasted an the jobsite
before the first inspection. If you intend to obtain financing, consult with lenderlor anlattorney before
commencing work or recording our Notice of Commencement. i
k'i s
:SIg/naturf 0 er/Lessee/Contractor as Agent for Owner Signature of Contractor/Liceh'se Holder
(I i
F FLORIDA STATE OF FLORIDA
OF _�%_ ,L hf� COUNTY OF I L �
,4
The forgoing instrument was acknowledged before me The forgoing instrument was,ackno i ledged before me
this Z day of /If0 20 /Lby this day of 20 by
ame of person acknowledging) (Name of person acknowledging) I
(Signature 6f Notary Public-State of Florida} (Signature of Notary Public-iState of Florida}
F
Personally Known t/ OR Produced Identification Personally Known I OR Produced Identification
Type of Identification Produced Type of Identification Produced I
I i
Commissic ; ' •. RAND01 N MCr EL Commission No. (Seal)
MY COMMISSION N FF915QDt
Revised.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGE IATION�°'` SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
i DATE j
COMPLETE ' III
INITIALS
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