HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MIST BE COMPLETED FOR APPLICATION TO 13E ACCEPTED
Date: 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 here 1
PROPOSED INPROVEMENT LOCATION;
Address: (Di '53 ,A
Legal Description:
cca`c�C2 of ��C3 Ll 1 � —Ly—
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PropertyTaxlD#:U Lot No.
Site Plan Name:
Project Name: Block No.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
� , \ `k
CONSTRUCTION] N FORMATION:
Additiona wor to e e orme un er t is permit — c ec
HVAC �G Tank ❑Gas
a appy:
(�
11
Piping
Shutters
Windows Doors
Electric ` Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: S
Utilities:Sewer [:] Septic
Building Height; _
OWNER/LESSEE:
CONTRACTOR:
Name a Q �Ce �1 �
�lM1
Name: J`I 9 —. rrjnn i
Address:
City: ��o State.
Zip Code:Fax:
Phone No,
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
U
State:
Zip Code: 1 C { Fax:
Phone Na.
E -Mair L`� i - C= csali
State or County License �l
If value of construction 11 $2500 or more, a RECORDED Notice of Commencement is required. J
Name:
'Addresst
City:
Zip: Phone: State:
1�1:E SIMPLE ITLE HOLDER.
- — Not Applicable
Address:
City:
Zip:
Phone:
I certify that no work or installat'
' MORTGAGE COMpANY:fS
Name:
. _ Not Applicable
AddC25s:
City;
Zip:
State:
BONDING COMPANY:
Name:
,,w._ Not Applicable
address:
City:
Zip' ------� Phoria.
run has commenced prior to the issuance of a permit,
St, Lucie C°linttyy raekes no representation that is grantln a e
which is in lease c with any applicable Home owners Associatio lt'uifl authorize the ermp
structure. Please consult with your Horne Owners Association and review your deed fo
n rules, bylaws or and covenants that Wray restrsubjectcah acture
in consideration of the grantrng of this requested permit, l da hereby agree that
in accordance with the approved pians, the Florida Building Lades and St, Lucie I r any restrictions perform
he apply.
P prohibit such
will, in all respects, perform the work
The following building permit applications are exempt from undergoing a €ufI ca
accessary structures, swimming linty Amendments.
t= pools, fences, wails, signs, screen roams and accessary uses to another non-residential use
U1�AtiNIiVG T® OWNER: Your failure to Record a Not, Of of Cony�e concurrency review. roam additions,
improvements to your property, A Notice of Com e
before a first ins ectian. If you intend to obtain financin eo uement may suit in your paying twice for
co encs rnencement must be recorded and posted on the Jobsite
r or recur i lir Noticr? of C°mmencem nsu
ttorney before
L or:.uwner/ Lessee/Agent
STATE OF FLORIDA �D �
COUNTYOF Cz PipCz
The€o day of. ping instrument was
this& acknowledged before
'C�,�.�
20 Lab
'Name Batson
Personally Known L--�.
D
Type of R Produced Identification
Jdentification Produced
Commission No.l� `— r
(seal)
Revised 07/15/2014
STATE OF FLOR
COUNTY OF
The forgoing ins. ument was acknowledged before m
this [ f day of _ ,
20 by
Personally Known [� ••"+rin►+�r•-
Type of Identlflcatiorz od c Produced Identification �
Cammfssion No,
(Seal)
REVIEWS FRONT ZONING
T COULTER REVIEW SUPERVISOR PLANS VEGETATION
DAVE REVIEW REVIEW SEA TURTLE MANGROVE
CC)MPLETE REVIEW REVIEW
REVIEW
INITIALS