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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 10-3C?' ko< Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginio Avenue, Fort Pierce FIC 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of liney�tCoj PROPOSED IMPROVEMENT LOCATION: Address: 4AbLA M Le al Description: ()t o C} S 1 Gi - IF W �- Property Tax lD #: 7-1A L -f - Q ©{,n - 0 a - 27' Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: C"�'S�e,r` l Ilis Ste' -rV- CONSTRUCTION INFORMATION: otiona wor to e e Orme un er t is permit - c ec a appy: VAC �GasTank ❑Gas Piping Shutters Windows/Doors Electric E:1 Plumbing Sprinklers Generator 0 Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ 0_ - iz)ro SFt. of First Floor: Utilities:Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name: JAMES F GRIMES Name Address: IL{yD �- Company: GRIMES HEATING AND AIR CONDITIONING City: - 4eAL2 State: _ Address: 3054 N US HWY 1 Zip Code: 3-k 9L'l`t Fax: City: FORT PIERCE State: FL Phone No. 1L - S Zip Code: 34946 Fax: 772-461-8722 E -Mail: Phone No. 772-461-8711 E -Mail: KAYLAGRIMESAC@AOL.COM Fill in fee simple Title Holder on next page I if different State or County License: RA0018071 from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of commencement is requirea. DESIGNS ENGINEER: Not Applicable Name: MORTGAGE COMPANY:�Q Not Applicable Name: TT66 Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY:�jNot Applicable Name: '"' 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 intend financing, you to obtain consult with lender or an attorney before commencing work or recording our Notice of Commencement. S ature of Owner Lessee/Contractor as Agent for Owner S ature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ST _ l,U C_k COUNTY OF S`T-- �__QC 1 The forgoing instrument was ack�nooedged b fore me The forgoing instrument was acknowledged before me Kby chis=� day of L c U! , 20 L this�O day of UQ Cj b GV , 20 by _ -" "=Es - (;i2\ M�_-s M -r- (Name of person acknowledging) (Name of person acknowledging ) (Signature of Notary Public- State of Florid (Signature of Notary Public- State of Florid Personally Known OR Produced Identification Personally Known` OR Produced Identification Type of Idenwicatio Produced Type of fdentificati9n Produced Commission N Commission No. (Seal) kN MONi?C ..:s MY COMMISSdON 0 GG 064Q99 ; :?;^• 4 . SUSAN MONTENEGRO rn�, I',�tit Ur,dd1.nten COMMISSION r GG 089M Revised 071 EXPIRES April 2.2021 80,0d Th U NO3fyP� U,,4&Wrgel REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS