HomeMy WebLinkAboutbuilding Permit ALL APPLICABLE INFO MUST IBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �a01 LJC) I Permit Number:
I$Y�46
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 1
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 1_,,ak4e, V f S7` rrCld _ff/C? ✓f` L���6C'
Legal Description: v TA -T /,? i /
a---I v 6>
Property Tax ID#: Lot No.
Site Plan Name: � Block No.
Project Name: L' k�- �lrL
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
01-L r C0"ldi`�i On i►I7 Crt-f1 i-�
TC� I to SEA W 1,4 % S K W e.I C F�°l e 1 � T- - �,✓ �' _si -,r-Nc�l
CONSTRUCTION INFORMATION:
Additional work to e nertormed under this permit—check all tha apply:
Ful
MHVAC D Gas Tank ❑Gas Piping _Shutters Windows/Doors
_Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ "T oer7 1p, Utilities: 0 Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Pwnp I ;Q C.t7 Name: V` QL&(a t P,-n c
Address: � 1 kAn_J(e_ IcS � �,�GLi i' Company: r1 ! i�` �✓e r _
City: Vor+ S+ .Lixe m_ State: Address, yytnl(e,
Zip Code: 5Q Fax: E� City: j-N+ State: t~tom
Phone No. Zip Code: (5qqRFax: _
E-Mail: Phone No.
t
Fill in fee simple Title Holder on next page if different E-Mail: (A (ak f,Ccfe_ a+
from the Owner listed above) State or County License: 0_'A(2_ to-3
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCT ON LIEN LAW 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 _
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature o._,. ctor/License H I r
STATE OF FLORIDA STATE OF FL RR
COUNTY OF COUNTY OF I
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 _by thisr` �day of ->C ,20 by
�k'v be
(Name of person acknowledging) Vn.k ledging)
(Signature of Notary Public-State of Florida) (Signatur of N tary Public-State of Florida)
Personally Known OR Produced Identification Pers ally Known OR Produced Identification
Type of Identification Produced Ty e of Identification Produced
0.
Commission No. (Seal) Commission Nozrfvl ll to.. ea IiMARISISABEL(3N'
* N
*IfkN ISSION#FF914191
F 9141
,ykF EXPIRES:August 30,201
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS