HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date:
Permit Number:
Ift
- 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
PERMITTYPE: rr��--��
Fen ce— Paf-""v-
,ROPOSED"INPRO.VEMENT LOCATION:
Address: 2�J2 Ir;ci ua�s ���y 6�t �<«�t 3y5ytr
Property Tax ID#: Lot No.
Site Plan Name: Block No.
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1
Project Name:
DETAILED DEtSCRIPTION OF WORK:.,.3, -
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ICONSTR.U.CTION INORMATI01U � �, >='°tz � �' +,
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank Gas Piping —Shutters Windows/Doors
Electric _Plumbing _Sprinklers —Generator _Roof pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ y Utilities-, —Sewer —Septic Building Height:
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OWNER/LESS E: � � - ° ,, �, CONTRAGTOR ��
..1. /
Name C�ar�e3 ��`(_ Name:, .,. � .c�cf Cs1wa��As Co �LC�
Address: 2�ISZ '1 v� Company: S I•F�
City: ri 0,or— State: R Address:
_ `
Zip Code: 3ti�V� Fax: City: l/� ��� State: IrL
Phone No. -172- -q'L 5-Z7�5 Zip Code: 3-ZfGZ" Fax:
E-Mail: Phone No It 7- -/,?
Fill in fee simple Title Holder on next page (if different E-Mail
from the Owner listed above) State or County License CG
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If I' "of HVAC is$7,500 or more,'a RECORDED Notice of Commencement Is required.
cif y `Y t•, - f f e5 ;� 1•R•-EER: �- d -
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DESIGNER/ENGIN �. � •
Applicable MORTGAGE COMPANY: Not Applicable
_,._._Not A licable
f Name: Name:
Address: Address:
i
Zip City: State: City: Phone State:'
Phone-. Zip:_,._.�.--
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING•COMPANY: Not Applicable
Name: _._.
Name:
Address'
I City: Address:
Zip:
Phone: Zip:CitZip:�.,,�,.._....Phone,
OWNER/CONTRACTOR AFFIDViT•Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to he issuance of a permit.
St.Lucie County makes no representation that is granting a ermit will authorize the permit holder to build the subject structure
which is in conflict.with an a licable Home Owners Assoc ation rules,bylaws or and covenants that may restrict or prohibit such
structure.Please,consult with your Home Owners.Associatio�n and review your;deedfor any restrictions which may apply.
in consideration of•tlie granting of this requested permit,I do hereby agree that I will,in all respects;perform the work
in accordance with the appfoved 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 TOS 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 onthe 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 Commencement.,
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i 6afure 0 see/Contractor as Agent for Owner Zignature of tractor/License Holder
4.1
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF `:r—, aa„_. R.: COUNTY OF o•,•,..
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged.before me
this' day of�' an..w0...•i .20� by this'3`t day of, Qan u..r,,� .20� by
Name of person making statement. Name of person making stat ment.
Personally,Known N OR Produced Identification .r' Personally Known fJA OR Produced identification,
Type of Identification Type of Identification, ,
Produced� Produced F L
' wani Cnrt `
gnature of Notary Public-State o ) MOfFlOrido ignature of Nota�ri -State of Florida) �f. ng
Commission No. (obi { �CoMMW'on'XP'es0 NotatyPublic
��•"� Sea "�,fission No. /'a�`j/�'�-`t U f Z Seal
Coininslon Na GG 22 6T { Comm of Florida
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�Y ion a puns 08/03
•REVIEWSVEGETATION SEA TURTLE MANGRO E
_ ERC+NT ZONfNG Sl1PERV1SCtR PIANS
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.