HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
5 J =
` Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F! 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 IMPROVEMENT LOCATION: �,
Address: t 2 �`� tee_ roti
Legal Description:
Property Tax ID#:3Ltc0_- (ao8--py,3(,o a,o- L/ Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
� ' F c -5'c0
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit - check all appy:
HVAC Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
Electric Plumbing Sprinklers 0 Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 0J�7 Utilities: Sewer LJSeptic Building Height:
ER/LESSEE:
rauu1 epa. '_r e v
City: c�oj; d . +� State•.'
Zip Cade: 3 `_5_5_0 Fax:
Phone', No. 93 l —J r� T `4 L -f
E -Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
CONTRACTOR:
Name: k5'_' " , 'n 0-\
Company: Cho ! �- A- C r:
A' � u 'crW "N
Address: v r vC .
City:v r t e State: .
zip Code: 5519 V.�L Fax:
Phone No, - ` 'i'S'
! ,/� [I
E -Mail: j.)� I� �
State or County License:e-
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SgPPLEMENTAL CONSTRUCTION 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: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
MAIM L'`DI -0% 9rn w/+�i.w a
�Y• ����� ..w a Fu.a.r vn Arriuvi 1: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 your Notice of Commence -ms -n+
SlgWature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA r
COUNTY OF • r
The forgoing instrument was acknowledged before me
th4� day of /`moi 201
/—Cyd a+^� (-�—� . • -� .--�
—Name of person making statement
Personally Known OR Produced Identification
Type.of Identification
Produced
— IIUAJ //��
{Signature of Notary Public- State of Florida j
Sign re of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF 4 - -�
The forgoing instrument was acknowledged before me
thiQA,. day of ✓`� �= 20iSr by
Name of person malting statement
Personally Known OR Produced identification
Type of Identification
Produced
{Signature of Notary Public- State of Florida )
Com r' ission No. �,�_�__. {SeMlIkE MARTIN Commission No.
Notary Public - State of Florida
iommis31on # FF 216951
REVIEWS FI
CO
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/27
PLANS VEGETATION
REVIEW REVIEW
(seal)MIKE MARTIN
Notary Public - State of Flor
Commission # FF 216951