HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1L -1S - % 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 _k-7) Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 15 tA!a N J�s\ R ISIS
Legal Description:e,Pc, 10,ax 7p Qf Prk\ axdbC f -W Ukli j- �G TD_s c x)d
Sax yck SSL 2_Z
Property Tax ID #: 1!J 1 to - to lZ - hh� r� - (,y�(�� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Sack:
Right Side: Left Side:
k inS 3A\ oj-i c5Y1 C>� for' 1 % V -c 4 T o '-� CCLY r % e -Y
W0J'C Y' SGUXtt_ 4tiP� FuJV--P I ii3 e£?_ t� b �(_w
CONSTRUCTION INFORMATION:
AC ditiona wor to a oe orme un er this oermit -check a aoo v: _
VAC 1J Gas Tank ❑Gas Piping U Shutters ❑ Windows/Doors
Electric 0 Plumbing Sprinklers 11 Generator 11 Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ S1 t-koo QO Utilities: Sewer Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name 'y ri W (1 SY1
Name: JAMES F GRIMES
Address: 'DDH l Al FN VI 1! 'J 7 lSIJ5
Company: GRIMES HEATING AND AIR CONDITIONING
City: FA 9 1(Ue State: L
Address: 3054 N US HWY 1
Zip Code: X1941 Fax:
City: FORT PIERCE State: FL
Phone No. -1-17- - 44 1- - LI U n
Zip Code: 34946 Fax: 772-461-8722
E -Mail:
Phone No. 772-461-8711
Fill in fee simple Title Holder on next page (if different
E -Mail: KAYLAGRIMESAC@AOL.COM
from the Owner listed above)
State or County License: RA0018071
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
VE510NER/ENGINEER:
Not Applicable
Name:
Address:
City:
State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: v*)
Not Applicable
Name:
Address:
City: State:
Zip; Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
}Not Applicable
which is inoconfliccttwith any applicable iHome OwnersAsssociapermit
l Association rulesabylaws or andpcovenants that may rthe estri k o prohlbit 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 recordina our Notice of Commencement_
c
ature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S �COUNTYOF .--C i \lr % T --
The
The forgoing Instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day day of �V Jnn { Y ., 20 S -by this day of —NLNl f.k-A. irn-.�20 , 9< by
1 J FAME
(Name of person acknowledging) (Name of person acknowledging)
{Signature of Notary Public- State of Florid (Signature of Notary Publlc- State of Florld
Personally Known _�J OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identificatio Produced
Commission N Commission No.
AN MON 'h R0
S� c MYCOfwIMISSIQNt,GG089034
Revised 07/ %J fA"' Ba 0ed 01 "' ktterf PuCic Undervmter�
REVIEWS + FRONT I ZONING
I
COUNTER + REVIEW
DATE
COMPLI
INITIALS
SUPERVISOR PLANS
REVIEW I REVIEW
(Seal)
SUSAN MONTENEGRt)
C0MMJ8S10N 0 GG 089039
EXPIRES. APN 2. 2021
! T�v Notary P"; UndKx "
VEGETATION + SEA TURTLEI MANGROVE
REVIEW I REVIEW REVIEW