HomeMy WebLinkAboutBuilding Permit Application 1
All APPLICABLE/ 'INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /`
Date: t-(1� 1 5' \t Permit Number:j 2)' 0/,
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n 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 IMPRCNEMBNI LOCATIONo
Address: 33? . t.\/.\P �� .a c: lactiC�
Legal Description:` 1 -0.T C.— E '•-)C
Property Tax ID#: 39,b3— ?DS QO -,2- Ono — B' Lot No. QZt13
Site Plan Name: Block No. S.—
Project Name:
Setbacks Front Back: Right Side: Left Side:
FAILED DESCRIPTION OF WORK°
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CONSTRUCTION ll 1FORMATIONo ,
Additional work to be performed under this permit-check all that apply:
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_Mechanical _Gas Tank ` _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:.
Cost of Construction:$ .27277 S Utilities: _Sewer _Septic Building Height:
OWNER/LE=61EE: ' CONTRACTOR
Name .MGUS# NOV(./ Name:: ere,..-)g--
Address:"332_ Sy-IAt_c_s,J("op ftV6 Company: E-64-)C....450 \Nj L-L __
City:. FO P 16Y�-Ccc- State: & Address:5-(& NLA,) T tY ) PLO
Zip Code: -. e.(`',r? . Fax: City: • State:f-t
Phone No. Zip Code:_ 3.?-1 3 Fax:
E-Mail: Phone No:. - 525-Cor7'7
Fill in fee simple Title Holder on next page(if different E-Mail 66305-V-,D lJ O eS)M&t -, CCM
from the Owner listed above) State or:.County License -3357)9
If value ofconstruction is 2500 or more,a RECORDED Notice of Commencement is required.
V°PLS.- ' EN AL CQNST'R1Ual®N- 11-1N Mg N KA MATI@Ng` '°* :° ,
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:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: 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
comme a 'n• work or recording your Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF '�.LIG0,1{ COUNTY OF c..51 .Lc,
The folgoing instrument was acknowledged efore me The forgoing instrumentjs.acknowledged efore me
this day of ,�[fr- ,20 y this day of OC.4 , 20/ by
1 ohe7i-- i i%i,', -6. -- 4,bee,-- J/--4AJ- _
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State/Florida ) (Signature of Notary Publ. Sta a of Florida)
Personally Known OR Produced Identification4,„' Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced 22 L.___ 4:„,..,,,,,,,,,, Produced �L ;a *'N 1
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REVIEWS FRONT ZONING :, �1� ' PLANS VEGETATION SEA TURTLE ,.+gc el 1,."
COUNTER REVIEW Iv• a E8N, 1 REVIEW REVIEW REVIEW 1411
DATE 0,- ..=• in 0.-u
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RECEIVED pg c z 0° I �� z
DATE
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COMPLETED N--.w v V ND.w.`0
Rev. 7/2014 m N
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