HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1--�2 --05 / 201 F,
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 X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: IciL Av,)i
Legal Description: 3 L>(® q0 FfQCH rQC( NL °,S 5D FV
1VA E 94Cf1 fg;� Pte; TF1 Co.1T,Y���, e 120 FT, TH S 1� ff J�1,1 `�� r�
Property Tax ID #: 3403 - 3t3� - 0oo2i DW _+Lot No.
Site Plan Name:
Project Name: C► C3n9c oot
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Block No.
Rcmovc old a i i� unit clod t nso! I oc-_,�iv) c -ii r ten'1
q ins 14 Siff -:R uv r1 h 1 k� ei c -n c h er' f: -O ►' 1re5� 6entj aj
pfcp�-t, .
iumonai worK to oe errormea
®HVAC Gas Tank
unser anis permit — cnecK an
❑Gas Piping
apply:
1:1_ Shutters
Windows/Doors
_
Company: Y Inc"
Address: J ,; \K) 4 ^`f i� < -v� t
City: &awt f� e, State: -EL
Zip Code: Fax:
Phone No. n2
11 Electric ❑ Plumbing
1-1Sprinklers11
Generator
1:1 Roof
Total Sq. Ft of Construction:
Cost of Construction: $ `J_ `.)9
Sq. of First Floor: _
Utilities: E] Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name E'1 e Qp*ya66cancoi cow -P.
Name: &Aen
Address: 181-- GW Krnbe'flu Nx- 1 L
City: RYT �1Qf � �Y:A C State: f
Zip Code: �)4%3 Fax:
Phone No. 112- - Z09 - ��C)(-
Company: Y Inc"
Address: J ,; \K) 4 ^`f i� < -v� t
City: &awt f� e, State: -EL
Zip Code: Fax:
Phone No. n2
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: In600fg�rcgye Ccs-; a net
State or County License: CINC� N60(&3
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
X Not Applicable
Address:
Address:
MANGROVE
City: State:
Zip: Phone:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY:
Name:
XNot Applicable
Address:
Address:
DATE
City:
City:
Zip: Phone:
Zip: Phone:
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 1 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 Jlotice of Commencement. ,
_ Signature of Owner/
STATE OF FLORIDA STATE OF FLORIDA A
COUNTY OF -_ 1> Wt COUNTY OF _s0 l i�{�a . crc
The forgoing instrLyngnt was acknowledged before me
this S day of VYI�C 20 I.Bby
ng )
Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced of
,.....
Commission NoC l /`I * ISSION#FF 914194
IP RES: August 30, 2019
WZ Bonded ThM 8uc d Senloes
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this '9. day of CbFXV 20 b�) by
of N,ibtary Public- State of Florida )
dally Known _ X OR Produced Identification
of Identification Produced
Commission No�-fv/ /`1 AMA ISISABELQ&
* * (lily COMMISSION # FF 914
EXPIRES. August 3o, 20
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS