HomeMy WebLinkAboutBuilding Permit ApplicationAll AtPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date* Permit Number:
ionaI work to be performed under this perm it -check all that apply
Mechanical _Gas
Building
ring and Development Services
iing and Code Regulation Division
Virginia Avenue, Fort Pierce FL 34982
ne: (772) 462-1553 Fax: (772) 462-1578
Permit
Commercial
Application
Residential 1/
Plo
Sol
23
Phi
PE
MITTYPE:
_Generator
Sq. Ft of Construction:
Address: 2/0/ W. /i'F/u� �: e /v al wc/O
PR
POSED INPROVEMENT1 LOCATION:
)f Construction:$
3000' J
Utilities:
Address:
/ 5 Z V ArODr Ave
®o-+ 5LA
LHt..e X77(
3 2
Property
Tax ID p: 3 V/C/ — S/
5 —006.6
— 000 —
Lot No.
Site Plan
Name: C 6444 !3 7
0 d-
Block No.
Proj
ct Name: ✓
DE
AILED DESCRIPTION OF. WORK:
C c/', e pit L;
e ¢
/�`Ge i
e-
17-5,/1rj.t Stre,iar /7fi
COO
/seP;
F",d 113 lJ7'And
Aire
ionaI work to be performed under this perm it -check all that apply
Mechanical _Gas
Tank
_Gas Piping
_Shutters
,Electric
_Plumbing
_Sprinklers
_Generator
Sq. Ft of Construction:
Address: 2/0/ W. /i'F/u� �: e /v al wc/O
Sq.
Ft. of First Floor: _
)f Construction:$
3000' J
Utilities:
_Sewer _Septic
—Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Address:
Cit
Zi
Ph
P
E -Mail:
Fill
from
ro r ,e3 L2
6+ AWOO 0( Oo
Name: oo Ch
/rig SPS 7< /ir%ar ve
Company: /W^e5d'
v: oo, VL S'/ L N 4 /� State: F 4
code$ L%�1 S 2 Fax:
ne No. 7 %Z 200 7763
Address: 2/0/ W. /i'F/u� �: e /v al wc/O
City: ��,ri�anO )Reu, /r State: F-
Zip Code: 330bI Fax:
Phone No 9 S'f 3 -7-5'12
in fee simple Title Holder on next page ( if different
the Owner listed above)
E -Mail / o^ e s a- A e c o rp [Dyq /r el0, C om m
State or County License L^
n vae ofconurunion is>zauu or more, a newnvcn nonce or,iau ncn«n, nn tv,a ,
If valise of HVAC Is $7,500 or more, a RECORDED Notice of Commencement is required.
SU
PLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
ontractor/License Holder
DESIGNER/ENGINEER:
Na
Ad
Cit';
Zip
e:
_Not Applicable
MORTGAGE COMPANY:
Name:
_Not Applicable
ress:
Address:
forgoing instrument was acknowledged before me
30 day of -So f\UAN _ 20A by
State: _
Phone
City:
Zip: Phone:
State:
FIEN
Na
Ad
Cit
Zip
SIMPLE TITLE HOLDER:
e:
_Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
ress:
Address:
('
Co
:
City:
ure of NotaryP c-5 ida,.,.laelCH CG60
07$2 RES Mercn 01,2
fission No. �a. ,�•- (Sesa1'f
Phone:
Zip: Phone:
FRONT
COUNTER
i/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
that no work or Installation has commenced prior to the issuance of a permit.
Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
in conflict with any applicable Home Owners Association rules, bylaws or an coven ants that may restrict or prohibit such
Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
leratlon of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
lance with the approved plans, the Florida No it ding Codes and St. Lucie County Amendments.
The )I lowing building permit applications are exempt from undergoing a full concurrency review: room additions,
acce sory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WA tNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
imp ovements to your property. A Notice of Commencement must be recorded and posted on the jobsite
bef re the first inspection. If you intend to obtain financing, consult with lender or an attorney before
...L .. -rAi, r nlmlle of rnm,ncn,crnnnt
ontractor/License Holder
Slg
ture of Ow ssee/Contractor as Agent for Owner
ST
C
JE OF FLORIDA
UNTY OF R'IDL..)ay
STATE OFF ORI D
FFLORID
COUNTYOF I 'fclWayc�
The
thi
forgoing instrument was acknowledged before me
30 day of -So f\UAN _ 20A by
Theforgoing instrument was acknowledged before me
this n) day of San_ uovTGt _ 20_Lq by
uod
A,A Gd'Q
Na
Personally
TyT
ne of person ma king statement.
Known 11_�OR Produced Identification
a of Identification
Name of person making statement.
Personally Known 11� OR Produced Identification
Type of Identification
Pr
duced
Produced
a
('
Co
[ of tory Pub c -S rl yr uweiru,w
mission No.�6rO7fr - �`�;e MIlSION 00^
„ RES Much 01,221
a
ure of NotaryP c-5 ida,.,.laelCH CG60
07$2 RES Mercn 01,2
fission No. �a. ,�•- (Sesa1'f
R
VIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
D
TE
RE
EIVED
D
TE
C
MPLETED