HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:c2'-ltj-IQ Permit Number:_
Building Permit Application
Planning and Development Services
Building and Code Regulation D'vision
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial ----Residential ----
PERMIT TYPE:
Lot No._
Site Plan Name:;;or-----------,-------------------Block No._
p~~Name:~&+~~1~m~n~~~~I~~~_
,
~kJ--~~~L&k~c~-~p~u-~~~~~C~~~~~~~f~~~cl:----------------------
Additional work to be perforned under this permit -check all that apply:
_Mechanical Gas Tank _Gas Piping Shutters _Windows/Doors
~Electric Roof ____Pitch_'>Iumbing _Sprinklers Generator
Total Sq.Ft of Construction:-#
Cost of Construction:$~o+;-",,~-,,~O--_
Sq.Ft.of First Floor:_
Sewer _Septic Building Height:_Utilities:
Name _eJu-er'_
Company:/I llmerlC-Ml Ai.r-:t 6/t;JaL
Add'lh!1 /IluJ !lJm:r:.,a:lzL~8.
City:~State~
Zip Code:3-{qj?f.p Fax:77k?7tf~SI'-Ilf
Phone No .,7~-J>7J?-S/tl3
E-Mail~~J 1]oVn (;:>o-o"f1eLnL.c-t:rh
State 0 ounty License tt!OCQ:2t.j3.!P
&RIlESS£E;ik '""";'~~_.;i_,i£fr-,,,}t,,;'k._._.,'{,tt!-c':,i -"
Name f4,~t--~Ji)+r1.t()~~t-
Address:16Y2L5 {fla ..lJe5 eul(Jf,£;c
City:PSL State:~
Zip Code:3tfi!Le Fax:_
Phone No._
E-Mail:_
Fill in fee simple Title Holder on next page (if different
from the Owner listed abc vel
If value of construction is $2500 or more,a RECORDEDNotice of Commencement is required.
If value of HVAC is $7,500 or more,a RECORDEDNotice of Commencement is required.
MORTGAGE COMPANY:
Name:_
Address:------------------City:----:-.State:
Zip:Phone:_
_____-.-__.State:
_____Phone
FEE SIMPLE TITLE HOLDER:_Not Applicable
Name:-------_.------------Address:_
City:-.-_
Zip:Phone:
_Not ApplicableBONDINGCOMPANY:
Name:_
Address:_
City:_
Zip:Phone:--------------
In consideration of the granting (',Ithis requested perm;t 1do h~~~~Vil~U ~~n1will,I"~IImWDm,D;~orm tn~wor~
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:YOUI~FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROYEMElns TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SI rE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR ,~N ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
OWNER/CONTRACTOR AFI:IDVIT: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 the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structurewhichisincontlictwithanyappli:able Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with YOlJr Home Owners Association and review your deed for any restrictions which may apply.
•••
Signature of Contractor/License Holder
STATE OF FlORIM .
COUNTY OF ..:};t/-Luu£c STATE OF FLORIDA ,
COUNTY OF &LJ J CV(.;
The fOrqOing instrument was a :knowledged before me The forgoing instrument was acknowledged before me
this (day of ~~20J!l.by this n day of ~('U<ll.ll..f ,20.r).by
..1.M~V/;.'"4.4~1L...6QL-'(P.eJJ...I)k:.~!:--+·,~·::·:;:·~t5><:.UJ/!;fl/J1 tf;"dJt.[
Name of person making statement.•••~~••~';-'"Name of person making statement.Ii"~~;..'1 Personally Known J OR Produced Identific
~;·",••:••,l'.·"Type of Identification
D~!§U~!~_
Personally Known (/
Type of Identification
Produced ._
OR Produced Identific
Commission No ..r.:r9/;;;SS~1 (Seal)Commission No.fi:=fl:2J9!
SEA TURTLE
REVIEW
S~~IIei""""PLANS VEGETATION
REVIEW REVIEW REVIEW
ZONING
REVIEW
REVIEWS FRONT
COUNTER REVIEW