HomeMy WebLinkAboutfoleyMYEALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE 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
PROPOSED INPROVEMENT LOCATION:
Address: iGg 'v�-t1ULe--
i �C+w �1
OIS
i
Legal Description: ? � I � L-Ct' `'es f &o- / . K �5o
f_._o
5 z2
Property Tax ID #: 5 C 0
Site Plan Name:
Project Name:
Lot No.
Block No, 50
Setbacks Front Back: Right Side:
Left Side;
DETAILED DESCRIPTION OF WORK;
e VVIC +6 (A �`�a ii Al cc w W CSS oyA
A A \N
-eA 5A
CONSTRUCTION INFORMATION:
Additional work toe e orme un ert Is permit —c ec a appy:
H�VAC 11 Gas Tank E]Gas Piping _ Shutters
tric 0 Plumbing 175prinklers Generator
Total Sq. Ft of Construction: Sa. Ft. of First Floor:
Cost of Construction: $ i 2 - 0-0 Utilities: 0 Sewer 0 Septic
Windows/Doors
Roof
Building Height:
OWNER/LESSEE:
r
Name 0-41 n izzc�c
CONTRACTOR:
Name• ` 0 ci r
/
Address: c A
ve' n` '
City: e- C State: fit✓
Zlp Code: S� q SI.. Fax:
Phone No,-Y� i {� S 9 �
Company: ICSO
Addr- s; 1c; ,,
City: xc ri -£ 'C State:
Zip Code`--- q( L Fax;
Phone No.'t r s �
E -Mail: Ch I� j ltal inl�� � �n 6
�
E -Mail:
Fili in fee simple Title Molder on next page ( if different
from the Owner listed above)
If %IaI11a of t'2rnn . - Winn---- .
State or County License
_;C0C_1 , r
.,..,� VV11JL1uLk1V11 13.)L3uu VI I,IVIe, a Mr_LU IJtu 4vatice 01 Commencement is required,
3+ ti t'='
I'MX R�f`
FRONT
ZONING
'�"{�"�'Y
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
COUNTER
Address:
Address:
REVIEW
City: State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: , Not Applicable
BONDING COMPANY:
Not Applicable
Name:
dame:
COMPLETE
Address:
Address:
city:
City:
Zip: Phone:
Zip: Phone:
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 structure
which is In conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or 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 wilding 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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement,
S
_41gnatu6reof Owner/ Lessee/Agent �Si n ure of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF � - U COUNTY OF
The forgoing instrument was acknowledged before me
thi�"day of �f _ 20 LCI by
Name of per n_pcknowllgin'%
Public- State of Florida )
The l�F� forg�ing instru ent ws acknowledged before me
this .day of '� 'k 20 by
r
(Name of perWn acknowl
of NotaKy Pdlic- State of Florida )
Personally Known i�ORProduced ldentificati`"�"i4„r'y�, Personaii Known 'all if".
y l/� OR Produced Identification`
Type of Identification Produced = Type of Identification Produced Ak�.
Commission Nci.EE Ll ,�_J (Seal) V - •' Commission NJE: E:G tt (� t (Seal) � �1 •y''�`:`��4
r�irur,rl" +titi�i*�
Revised. 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
ELECTRICIAL RISER PLAN
NOT TO SCALE _
P— Underground
O Overhead
Grounding Electrod
❑ #f
#4
#2
❑ . Other
CONSTRUCTION TYPE:
Q
Commercial
O
Residential
Q
Mobile Home
Q
New Installation
Q
Old Installation