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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLI BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I l 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 ni PROPOSED IMPROVEMENT LOCATION: Address: ©151'{LAUY't�wnpci r i . Legal Description: NiQ nt_e_ C X ib UULV-1+YN _ I UJD " IA 4,2 ► T_V rK _f, - LID N 2156 Property Tax ID #: l2jZ-1 - 10 k - l)t)-1 Q` Lot No. Z5 0 Site Plan Name: Block No. Project Name: Setbacks Front sack: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: p,p p p, (C S stn � l� i 5 —.1� �t �IOIY � IJ. J►- � 5 Q XX to4IkN� [CONSTRUCTION INFORMATION: itiona war to Ueer-Formed un er L111b permit - UICLK all that appy: OkVAC Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors _ 11ElectricQ Plumbing ❑ Sprinklers 12 Generator Roof Roof pitch Total Sq. Ft of Construction: 5 Ft. of First Floor: 0Sewer'❑Septic Building Height: Cost of Construction: $ Do Utilities: OWNER/LESSEE: CONTRACTOR: Name �- k OY1 Name: JAMES F GRIMES ��` Address: �l_� a 1 ��'L•^ �►�11�[ac7� Company: GRIMES HEATING AND AIR CONDITIONING City: 1 e State: FL Address: 3054 N US HW'Y 1 Zip Code: ',t{ci 51 Fax: City: FORT PIERCE State: FL Phone No. -i-1 " y La 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 ( if different from the Owner listed above) State or County License: RA0018071 if value of construction is $25010 or more, a RECORDED Notice of Commencement is required. Name: ` Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City. Zip: Phone: MORTGAGE COMPANY: Name: _ Address: City: State: Zip: Phone: Not Applicable Not Applicable I BONDING COMPANY: Name: Address: City: Zip: Phone: 'QNot Applicable I certify that nttooy work or installation has commenced prior to the issuance of a permit, which is inoconFlicmtaw th anrepresentation alme Owthat is nersting a Association ru esabyl ws or andpcovenants that may rthe estrict 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 pians, 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_ ature of Owner/Lessee/Contractor as Agent for Owner STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 1COUNTYOF ST. l 1f r The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this`�._dayof 114dVe_1m e.v , 20 LZ_by this —�Lday of_ Nritl��r,.�1�,Qw 20 by � �= (Name of person acknowledging) (Name of pers`on acknowledging J Notary Public- State of Floridsignature of Notary Public- state of Personally Known OR Produced identification Type of identification doted Commission ,? MycommlSsI'ON#GG084099 Revised 071 eordea Tim, r�orory Eutic Urear nws Personally Known OR Produced Identification Type of Identifi ion Produced Commission No. (Seal) SUSAN MONTENEGRO C MMrSSrON R GG 089048 EXPIRES:ApN 2,2021 P� --- ,,., ,quay rvoic �.rilrrs REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW DATE REVIEW COMPLETE INITIALS