HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7—E"4 9) Permit Number:
-I J ' -I I_
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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: SG�t �p�r l� Ce $Ea0
PROPOSED INPROVEMENT LOCATION:
Address: 0\3�0 ebuVO
\
Legal Description: `LC��A►�� ��. 1T t-CJ� 7i�
Property Tax ID #: Lot No.
Site Plan Name: Block No. CT
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
AaClitional work to be performed under this permit - check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator Roof -�lrt(4pitch
Total Sq. Ft of Construction: Z�0pO Sq. Ft. of First Floor:
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Cost of Construction: $ 10.0000 . 0:2 Utilities: _ Sewer _ Septic Building Height: to
OW N ERAESSE E:
CONTRACTOR:
Name
Name:
Address: L 0
Company: ,
_
City: T7&0—?iP_rW_� State:�C_
Zip Code: �Z t ia Fax:
Phone No. �`l��—�(%gam 4;,602M.Zip
Address:
City: �,r, State:
Code:--'zq4 Fax: M—
Phone No — —1 .S6
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail`A mnLN 246110
State or County License O
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
I�
Name:
Address:
City: State:
ZIP: Picone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address: -
City:
Zip: Phone:
MORTGAGE COMPANY: 'Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Address:
Zip: Phone:
OWNER/ CONTRAC FGR AFFYLWkT: Application is hereby made to obtain a permit to do thework and instaitation 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 aythorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or antl codenantsathat may restrict or prohibit such
structure. Please consult with your Ftpme Owners Association and review your deed for any restrictions which may apply.
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In consideration of the granting of this requested pisrmit,Y do hereby agree that l 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 underganga full conicurreocy, review: room additions,
accessory structures, swimming pools,#ences, walls, signs, screen rooms aand'aecessor usesto�a&ther non-residential use
WA64ING TO OWNER: Your failure to Record a Notice of Commencement may result In yotic 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
signature or Owner/ Lessee/Contractor as Agent for Owner
STATE OFFLORIDA tt
COUNTY OF
The for a'ng instrument was acknowledge efore me
this day of � ,.-� ZO�y
tiwQ _ i. os%orar
Name of Mson making statement.
Personally Known- OR Produced Identification
STATE OF FLORIDA
COUNTY OF S� LV c&A&
The for oing inst ment was acknowledged -before me
this,, .%'` day of
Name of pe on making statement.
Personally Known OR Produced Identification V
?. of IdentificPien�l
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REVIEWS FRONT ZONING,: SUPERVISOR PLANS VEGETATION SEA -TURTLE„ MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW _ REVIEW REVIEW
RECEIVED
PATE
COMPLETED
ev. 8/2/17
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