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
2.300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential
Address:! .•. r �,� c,- v
Legal Description:
Property Tax ID #: ` ;r I' - .j J -oco ) �2 - - I Lot No
Site Plan Name; Block No.
Project Name:
Setbacks Front Back: Right Side; Left Side:
DETAILED DESCRIPTION OF WORK:.
el) iL
Z;
CONSTRUCTION INFORMATION:
nuuiuVitdl VVUFK [V ue errormea unaertnis permit-cr
(n"'`� HVAC _1:1 Gas Tank QGas Piping
11 Electric 1:1 Plumbing Sprinklers
Total Sq. Ft of Construction: /, .i- ;
Cost of Construction: $ y G
Illat apply:
_ Shutters
Generator
S Ft. of First Floor: _
Utilities: L-1 Sewer E]Septic
Windows/Doors
Lam! Roof Roof pitch
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name h/ c- c.
Name: e_5,r,3
Address: / L4 rl /I, C.L_�
_C
Company:
City:425- Ly State: i L-
Zip Code: 3 1 .s`".)- Fax:
Phone No.
Address: �zc
City -, s<� t �,'
Zip Code: 3 q SJ` 3 Fax:
Phone No.
State: J::•Y
1 77l -
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail:{
State or County License: _C A
c- ( j
.. su. are b 1JaJ U"ILPJ1 13 94LJVU Ul ,!JUJU, d rcccvnutu trouce or commencement is required.
SUPPLEMENTAL 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: Not Applicable
Name:
Name:
Ad d ress:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
MIAIRIEn rriwrrz w.+rr�a. .
--1—iii wir i KAL ii vR mrrmiv 1 I : 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 pians, 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.
I oL,"2-
Si of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF > 7— COUNTY OF 3 E— L ..� �—
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 4 day of 20tkby this cL day of. `(_ ,-F 20 i Q by
Name ofp er on makin statement Name of perso making statement
Personally KnownOR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
OR9
(Signature of Notary Public- State of FSignature7 Id, 0
of Notary Public- 5 to of ) "NOTARY p�g(,10
Commission No. � omDA mission No. /` %j/ 7 ;TATE OF FLORI
Comm# FF192528
Expires 1/25/201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17