HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ki-U _Q 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: ` $q ` v-ooje.eitsy' its
Legal Description: BL Ion G)'-yoVQ 51-b 12'L1K [ (,�-1 Z=?
Property Tax ID #:-311 n coq i - c)nc.:i - b Lot No. 7-3
Site Plan Name: Block No. 'C
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
IinStaJ�lraticrr� �� t(" �-Dv t+Ic-e Tn'I`)
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name x, 4 M c
Name.. JAMES F GRIMES
Additional work toe e orme under
Li Gas Tank
this permit - check
E]Gas Piping
a
appy:
Shutters❑`
Windows/Doors
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: KAYLAGRIMESAC@AOL.COM
State or County License: RA0018071
eVAC
lectric F-1_ Plumbing
Sprinklers
Generator
L=1 Roof Roof pitch
Total Sq. Ft of Construction:
Sq.
Ft. of First Floor:
Cost of Construction: $ q, qI)K) •Old
Utilities:
Sewer Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name x, 4 M c
Name.. JAMES F GRIMES
P
Address: I a (� t AnAnn ,� a _ L
Company: GRIMES HEATING AND AIR CONDITIONING
City: E!I uc e- State: Ft-
Zip Code: Ov8 Z Fax:
Phone No.`1-1I-LT'O_l_:4,4 Q
E -Mail:
Address: 3054 N US HWY 1
City: FORT PIERCE State: FL
Zip Code: 34946 Fax: 772-461-8722
Phone No. 772-461-8711
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: KAYLAGRIMESAC@AOL.COM
State or County License: RA0018071
If value of construction is $2504 or more, a RECORDED Notice of Commencement is required.
urNUNLIK/ENGINEER: Not
Name:
Address:
City: State:
ZIP: __Rhone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
ZIP: Phone:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
ZiP: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip; Phone:
4 Not Applicable
ANot Applicable
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucle 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
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4422� 'J'F
ature of Owner Lessee Contractor as `
/ / Agent for Owner S ature
C
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF f5i - U le t E COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of LIt ,U2mnn her 20 Eby this day of �)y� �{, , 20 by
(Name of ersonao�w din r
p acknowledging) {Name of person acknowledging )
of Notary Public- State of
Personally Known OR Produced Identification
Type of Identiflcatlo Produced
Commission Nu _! W.
of Notary Public- State of
Personally Known OR Produced Identification
Type of Identificat n roduced
Commission No. (Seal)
MYCOMMISSiON#GG089099 SUSAN MONTENEGRO
ry t WNIMISSION # GG 089099
Revised 07/ WAMThruNowy Pu is llnde+mivs='' EXPIRES April�� 800d tera 2, 2021
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