HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date. �� � Permit Number: 7
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Building Permit Application MAR 2 ® 201
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 I(VIPROVEMENT LOCATION `
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Address: S/01 Voa/e0 P)/us
Legal Description:
Property Tax ID#:- /3/2• $01• a)H3• 000- q Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: 45 Left Side: -60
DETAILED;DESCRIPTION O`F WORK h`
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CONSTRUCTION INFORMATION
Additional work to be nerformed under this permit-check all that appy:
❑HVAC Gas Tank Gas Piping _Shutters Windows Doors
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❑Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: d S . Ft.of First Floor:
Cost of Construction:$ 4 0 ; Utilities:n Sewer❑Septic Building Height:
OWNER/LESSEE HCONTRACTOR
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Name Name: C
��.'w� L' Goo�!^.� �U �o✓c,."n ,. ..
Address: ip°'TCO �'L's C'2 Company: Coed Co1zC� e,
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City:� State: Address:► 9/86 /DAl�,* 1,9�,e'
Zip Code: 3 Y%S1 Fax: City: Vero G! State: PL-
Phone No. 7 72 • Zip Code: 32,96 T Fax:
E-Mail: Phone No. 77 Z ys3 3y�'y
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: eec_ 13.3/0Z9
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
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 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 our Notice of Commencement.
L�D z2g� Z�G s
_Signature of Owner/Lessee/ gent Signature of Contractor/ icense Holder
STATE OF FLORID - STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledge efore me The forgoing instrument was acknowledged before me
this day of /77 Adan}F– 20I�by this day of bn AFLC 20by
m igran Tk&h mOrC�n .
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Ntly Public-State of FloriBa U
/ (Signature of N ry Public- tate of Flor da)
Personally Known r d ced I entificat}}'ppr�� / Personally Known OR ced I,d.��n,t.i Ication
Type of Identification Produce Type of Identification Produce :�!— (' •
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS