HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i1-% - lei Permit Number:
S- J -
•
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 >o
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line r 1
PROPOSED IMPROVEMENT LOCATION:
Address: a �1�+(��� 17e� M6Y_k-f_
Legal Description: :14 SS PrUL th-Wr IFPc�T "L, NE.1
-
Property Tax ID #: nC) - b Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
of i�4 C_ Y 2.v t `
wYJ: k- l ILA sF V'A1k-�l Vo YQ�-
anai worre wue erJuonie❑ unuer UM,Neinnr.— a
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HVAC Gas Tank ❑Gas Piping
Electric Plumbing ❑Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ LA .1) a0 • D D
appiy:
_Shutters Windows/Doors
Generator Roof Roof pitch
SFt. of First Floor:
UtilitiestSewer Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name: JAMES F GRIMES
Company: GRIMES HEATING AND AIR CONDITIONING
Address: i-7_-'N1-A_�1ni 12 "P_
City: N N . n -1/1a _ State'F _
Address: 3054 N US HWY 1
Zip Code: -2> z� 4$ lts Fax:
City: FORT PIERCE State: PL
Phone No. `-1b l-LkLA6- LL)15 3
Zip Code: 34946 Fax: 772-461-8722
E -Mail:
Phone No. 772-461-8711
E -Mail: ICAYLAGRIMESAC a@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 52500 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:
710 Not Applicable
City: State:
Zip: Phone:
Not. Applicable I BONDING COMPANY:
Name: _
Address:
City:
Zip: Phone:
,'[jNot Applicable
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, Ido 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, wails, 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 our Notice of Commencempnt-
ature of Owner/Lessee/Contractor as Agent for Owner Sature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5rt . _t { t F- _ COUNTY OF_ 4
The forgoing instrument was acknowledged before me
this day of N h+J 20 Eby
'A' J N ''nes ECJ rA F_S
(Name of person acknowledging)
of Notary Public- State of F
Personally Known OR Produced Identification
Type of Identifcati Produced
Commission
MY COMMISSION O GG 089099
Revised 07/ .7,1 i" a«wea Thru xaer, F,�ti under�nre�s
The forgoing instrument was acknowledged before me
this _ '�._ day of N D V � 20 k'�'K by
R � '1= b P I ir\n C
(Name of person acknowledging )
ature of Notary Public- State of
Personally Known OR Produced Identification
Type of Identificati6n Produced
Commission No. Seal
SUSAN MONTENEGRO
C hl' SSION R GG 089099
EVAES AP02.2021
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS