HomeMy WebLinkAboutBuilding Permit ApplicationLL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
s
Building Permit Applicatl0n
Planning and Development Services
Building and Code Regulation Division L 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
Address: TIO V'noll►Nood I alnr
Legal Description: Mo n f e._ Ca Y 10 C,C) U n E Y V CI U b -1 n i t t h Y - 10 H Ah1
for W149 - 110t1)
Property Tax ID #: 132-1 --1 O I - 0017 " 000 - I Lot No. 4l
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
We VWinstait AU gallon etectric Water heater
HVAC L_ PPluGas Tank uGas Piping
Electric mbing OSprinkiers
Total Sq. Ft of Construction:
Cost of Construction: $
WSRI0 ,
Shutters ❑ Windows/Doors
Generator Roof
SFt. of First Floor: _
UtilitiestSewer Septic
Address: � UJ Q k n n l l �nl b I a r P
City: Fp i' j- P I e cc P Stater
Zip Code: Ug �i I Fax:N 1 A
PhoneNo.AQAQ -90152
E -Mail: N I A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
if value of construction is $2500 or more, a
Name: f'
Building Height:
Company: -'SQVJ l .Yn 21►]mi9in i no..
Address: 4014 4 3Yd A V C n 1) e
City:?- N t 2 a stat
Zip Code:3201 Uo Fax: -1l2 -o118- 989 4
Phone No. M - sus- 6S?2c)
E-Mail:S'V' av_ o„thCVn lumbina(ajal
State or County License: 12 Foot I I (fio
Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit,
which in cont makes
with any applicable lHome Owners Asssociation ru esabylaws or and covenants that maydrestrict 6or 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 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 th st inspection. If you intend to obtain financing, cons�t with lender or an attorney before
comm ci work or recording your Notice of Commencernent/7
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
thisday of 20 jby
Notary
Known V OR Produced Identification
Type of
Commission No.i1S_L 1`2l 11( Zl" 5(yg.n ealMrnanPuorcstate or
N- Kristin Kylie Webb
1 My Commission GG t
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of 3 a Yl U'3 Y* 20 g by
I>6igrrdfy(re of Notary Public- ate o
Perso ally Known OR Produced Identification
Type of Identification Produced
No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS