HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6-7-9` lg Permit Number:
J
• 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
PERMIT APPLICATION FOR:���
PROPOSED INPROVEMENT LOCATION:
Address: 7713 l _ 14IQ/te-AA- _-;z'wo;5
Legal Description:
Z
Property Tax ID #: Z�f{Zl� %07/"' Ig1—A� " tJ Lot No. Z0
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
r ,l
CONSTRUCTION INFORMATION:
ACKlitional worK to Be DerTormed under this oermit — check ail t a� t
_Mechanical _ Gas Tank _ Gas Piping _ Shutters 7 Windows/Doors
_ Electric plumbing _ Sprinklers _ Generator V Roof 3rN IZPitch
Total Sq. Ft of Construction:' la Sq. Ft. of First Floor: /av0
Cost of Construction: Utilities: _ Sewer _ Septic Building Height: W I
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Addr ss: 77(
Company:
City: State:R� -
Zip Code: X%4SZi Fax:
Phone No. sb --ZSG � Z—S-7a
Address:
Citytam mg
/ State _
Zip Code:
Phone No 77 "SMS'—
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail
State or C unty License 3
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER ENGINEER: Not Applicable
MORTGAGE COMPANY: -SVot Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Z{p: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:^
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFHNIT: 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 arlthorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws orand codedantytfiaL may restrict or prohibit such
structure. Please consult with your I pme Owngrs Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested plirmit,`1 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 undergoi%a full carkcurrency review: morn additions,
accessory structures, swimrrung pools, fences, watts, signs, screen rooms a`nd'accessorf usestoarnother non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result inyo0rpaying 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
comrrtencing work or recording our Notice of Commencement
Signa ure of Owner/ Lessee/Contractor as Agent for Owner
Signa of Contractor/License holder.
STATE OF FLORIDA
STATE OF FLORIDA,,,:;,_
COUNTYOF � �GG.-
COUNTY OF
The fp ng instrument was acknowledge efore me
this dayof TAA�� 20�y
The for oing'nstr ment was acknowledge efore me
this -LS day �J1/�+ 20% acknowledged-before
of
Name of Mson making statement.
Name of pe on making statement.
Personally Known- OR Produced Identification
Personally Known OR Produced Identification V
Type 1 entificat' ,.�
a of Identific n
Pro ce f 'D L-1
r uced .
{Si ureME. o F(Orift
gnat F I`�ar1s
Commissio��Rtssp • ,�
4n►Exptrn y,2Q2T
Commission # GG
Commi .'irMet22 .
REVIEWS
FRONT
ZONING,
SUPERVISOR
PLANS
VEGETATION
SEA -TURTLE, ..MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
PATE
COMPLETED
Fe—v.
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