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) 452-1.553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 1,149C ) t� , } .
Legal Description:
Property Tax ID ##: (� 1( "(�i'�C Lot No.
Site Plan Name:
Project Name:
Setbacks Front Sack: flight Side: Left Side:
-PETAILED DESCRIPTION of WORK:
P,E, QC 4TF_ 'firm O ' �O
cAris . M)b O vEhi ijldSEK G48, i Ll6 N _rl )l/ ,
Block No.
I CONSTRUCTION INFORMATION' I
HVAC F]Gas Tank
&Ilectric In Plumbing
Total Sq. Ft of Construction:
Cast of Construction: $
Piping LJ_5hutters
nklers E Generator
S. Ft. of First Floor: _
Utilities t n
Sewer L t Septic
E]Windows{Dorms
Roof Roof pitch
Building Weight:
OWNERAESSEE:
CONTRACTOR
Name .PA,,JIA BeAoboiii
Name: T f i. op, gN(;rL M I"JAl
Address: 1 *�?Q'* U,600R, 96C-6 &_O
company: A:'c ter' f$c-'rkic: f Cbm-j,2.le7j—jAi6 »ic
City: pprI--M cln� State: FL
Zip Code: ,4 iq 8 Fax:
Address: 7173 G01107I Pl-
City: ,,R:r Sr Lucie State: rL
Phone irlo _ /—a — 13`
Zip Code:`f5 Fax -
E -Mail:
Phone No. 17, -7 5'
_
E -Mail: Accok/ri e eiFEC71 riC_ P-qL C31 C61`1
Fill in fee simple Title Fielder on next page ( if different
from the Owner listed above)
State or County License_ 6C C 0030a
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
_ _ E — -1 uuy mace Eo omain a permit to Cho 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 Coun A d
1Y men menu.
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 fi inspection. you intend to obtain financing, consu ith lender r an attorney before
commend ork o c in our Notice of Commencement.
Of
STATE OF FL
COUNTY OF
as Agent for Owner Signature of
The forgping instrument was acknowledged before me
this _�iL day of _x� � 2p I� y
Name of person making statement
Personally Known, OR Produced Identification
Type of Identification—
Produced
_i
(Signature of Notary Public -Stat of Florida i -._-
Holder
STATE OF FLORID
COUNTYOF,
The fn-reoing instrument was acknowledged before me
this . day of 20L2�lby
Name of person aking statement
Personally Known OR Produced identification
Type of identification
Produced 2 Jam/
(Signature of Notary Publfc4tate- of Floridal....t.
Commission No. 01r / .. i/6 �����• C. VTR •��*y ��
,Z :tea p ��� Commission No. / �l61 % Ow
:ZS
�pR 4q
REVIEWS FRONT� � r — +• � ; �
TEG '�ffrWf ERVi§ 9 PIANS VEGETATION TR S r1�3lAlVGftO
COUNTERl� eQ„ �f REVIEW REVIEWedthV4
DATE t -
RECEIVED
DATE lilt
COMPLETED 11
Rev. 8/2/17