HomeMy WebLinkAboutRagan 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) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: ze 3S -4o � W-1 �'bLi>) 5-:0 Df' Sty— ,&0 5.
Property Tax lD ##: 2q7.,t ' 331 - � 0iny - 1D Lot No._
Site Plan Name:bfJ 6 �'J cc Block No.
Project Name: JZA° A.� Ce.eXG
� i
Setbacks Front I bot, Back: �` f Right Side: Left Side: t
DETAILED DESCRIPTION OF WORK:
1,,5 4, l l &' G4CL, Lr�{� �c-A3 6a-tCS, WV q3, LP—
CONSTRUCTION INFORMATION:
Add -it iona wor to n -e -pr Orme un er t is permit - c h ec
ElGas
a�ppY—:
Windows/Doors
E1HVAC GasTank Piping
hutters
ElElectric Plumbing O Sprinklers
Generator El Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
D Building Height:
Cost of Construction: $ Z3� o Utilities.
Sewer Septic
OINN ERAESSEE:
CONTRACTOR:
Name-
Name:
Address:S� �A'
Company: e'-ClC,rnS�'c
_3
City: t ` iC"e-- State: f`t
Address: 210- St-)
Zip Code: �t�Z Fax:
City: Ps L State: �-
Zip Code: � �fax: 772 �`"l_�6°�
Phone No.
E -Mail:
Phone No.
:C C rti//"QLc,+ kQ i�u°• o`°`^-
Fill in fee simple Title Halder on next page ( if different
E -Mail: C I
State or County License:
from the Owner listed above]
If value of construction is $25DD ar more, a REC(3RDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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
commencing work or recording your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA/
COUNTY OF ,:,p
The forgoing instrument was acknowledged before me
this D.�day of fir' 20 �fby
r I �
(Name of person acknowledging
(Signature of Notary Public- State r'F`P�T: :'; rI '11*
��� ySION iA • r�i
Personally Known OR Py_du.4�W1 ;;*--
Type of ldentifi tion Produced � .V_�_ 'fir
Commission No * (I�t7 �'�• c
o.
a�'
Pit tic 110
Revised 07/1512014
— %_y s
Signature of Contractor/License Holder
STATE OF FLORID_
COUNTY OF
The forgoing instrument as acknowledged before me
this day of /' 20/!?— by
(Name of person acknowledging )
(Signature of Notary PLVIc- State of Florida �..��1t11iI1HgJl�..
Personally Known,_ OR Produ
Type of Identification
lPrroduced
Commission Ni
' !rL i
*:seal) �.
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STATE.�.r\�
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS