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
Address:
Ocean bi-, Un'r-
Legal Description:',,,�LAQb WPES C01,3aomiN►um A UNR IS'3q
A/K/AADmt�Ac. �►�DOfr1INiU/11to(�'370$
IS`16)
Property Tax ID #: 3S3`J -(00 I -oO` 11, -ppp —O Lot No.
Site Plan Name:
Block No.
Project Name: b PS W) TT IW't
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION: OF WORK:
&a_r(� v�./ t -3
uo oA-Q C So U r ce_
�)t•� I t'1, 3 : Pef CI I Mq MCA.4 +Or +�e� P rn�
�► r` COn d. I -} I Dry i
CONSTRUCTION INFORMATION:
!bona wor to ewer orme uner
I&HVAC L_J Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ y��4 o�Cj 00
tiS permit — c ec a appy:
❑Gas Piping _ Shutters
Sprinklers EJ Generator
S Ft. of First Floor: _
Utilities:[]Sewer OSeptic
Name X0.2(
Address:_ ASO SOuTh octoa n 6 L, )i+ ji2q
City: a nW4n 8ea.eJ,_, State: ,F ,
Zip Code: 34Cf5') Fax:
Phone No. Q(Dq 3OL4
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
❑ Windows/Doors
ElRoof = Roof pitch
Building Height:
Name: -Dr �� 1 I-� �.�11r-A
Company:v 4�_tco— _v_d,
Address: 5?) -u�3 m ('2 aj )+c Lp e L i -ll I
City: b�( S+ . �.t l� a o f State -J:% -
Zip Code: Fax: 122 -°i34-35 I I
Phone No. -7-7a — �? ! — 1 SLOC)
E-Mail:pt`.YJit1C
State or County License: _�{� j j ►-j (� ,�
If value of construction is $2500or more, a RECORDED -Notice of Commencement Is required.
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• • •licable
ZONING
REVIEW
SUPERVISOR
REVIEW
• • -
• •
City: State:
•
• Phone:
City:-
SEA TURTLE
REVIEW
• • •
FEE SIMPLE TITLE HOLDER: • Applicable
BONDING + • Applica• -
Name:
Name:
Address:
A • •
• • •
• • •
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 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
commencinor recordin 4r Notice of Commencement-
----
Signature of Owner/ Lessee/Agent
Signature of Contractor/License
STATE OF FLORIDAJ STATE OF FLORIDA('
COUNTY OF Pct S+, LL, LL,L COUNTY OF T�x
The forgoing instr ment was acknowledged before me
this 2L day of e02/Mbef1 20 1-1 by
)31
me of person acknowledging)
The forgoing instrument was acknowledged before me
this'a.6 day of De-COInbPeA , 20 0- by
V(ip P)i -
(Name of person acknowledging)
(Signature of Notary Public- State of Florida) 1g ature of Notary Public- State of Florida )
Personally Known '� OR Produced Identification Personally Known � OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. o!""t"6 LINP"ARIE BOUCHAR Commission No. :►" "°,
NDA MA&416UCHARD
MY COMMISSION #FF125526
MY COMMISSION #FF125526
Revised 07/15/2014 (407) 398.0153
1407) 398-0163
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS