HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1_1 ((% t 12-( 9 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 TYPE: J C�
PROPOSED INPROVEMENT LOCATION.
Address:
Property Tax ID #: (L{ ' ( �J `� U �o�' Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-- check all that apply:
Mechanical —Gas Tank _Gas Piping TShutters Windows/Doors
_ Electric _ Plumbing _ Sprinklers Generator Roof Pitch
Total Sq, Ft of Construction:c ,rr Sq. Ft. of First Floor:
10
Cost of Construction: $ (0 A. - '1° Utilities: —Sewer —Septic Building Height:
MINER/LESSEE:
CONTRACTOR:
Name f"yt . '
Name:. ' ('
i
Address: (� i W4� l �i
Company t t
City: State:
Address: U Lt 1
Zip Code: �`� Fax:
City: •CC— l State:
Phone No. '4.0 J?
Zip Code, L Fax:
Phone No� _ —,2 -
E -M cm 1 L` tiA of 6"90k
,E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or Count}/Licensecf¢''.�� r3
If value of construction is $25U0 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name: Not Applicable
Address.
City:
Zip; Phone: State.
FEE SIMPLE TITLE HOLDER: � Not Applicable
Name:
Address:
City: _
Zip. Phone:
#Vii)Ri%AGE COiViFANYa
Name. Not Applicable
Address:
City:
:
Zi 5tate:
P _______„�,„+ Phone:
BONDING COMPANY:
Name: ,....,,Nat Applicable
Address:
City:
dip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit,
St. Lucie County make no representation that is granting a ermlt will authorize the ermit holder to build the subject strust'ure
which is in can �cc consult
any applicable Flame Owners Association rules, bylaws oran covenants that may restrict or r
structure, Please consult with your Rome 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 res Prohibit such
in accordance with the approved plans, the Florida Building Codes and St, Lucie County Amendments. .
pacts, perform the work
The fDi}During building permit applications are exempt from undergoing a full concurrency review: room additions
accessory structures, swimming pools, fences, wails, signs, screen rooms and accessory uses to another non-residential use
1IVAi��Ii�1G i® CDiAfNER; Your failure t® Record a �io'tice of C®mrnerrcem.errt may result in your paying '`vw
improvements to your property. A Notice of Commencement must be recorded and posted ori
before a first ins ectian. If you intend to obtain financing, consul i' y ice far
co encl r or recur theabsite
ut Notice of C�rnmencemp�� .attorney before
:_'signature 'of. i.dssee/Agent
STATE OF FLRICIA
[
COUNTY OF
,
�►'
� LE
The forgoing Instrument was acknowledgged be
thisthis IL'day ofILI
ameyaf person
j.15P IQ(.Ul t: ur 1v0cary Public- State of Florida )
Personally Known�JOR Produced Identification
Type of Identification Produced
Commn issioNo.
. � 7 (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR
.�.. COUNTER REVIEW REVIEW
INITIALS
NATE OF FI:OEt ? a
COUNTY CBF44
The fror.•g��oing instrument was acknowledged beforIm this&V ofd �
F� y moo
Personally Known —L
Type of Identification
C0MMIss10n Ido, 7 '' �I (Seal)
PLANSf VEGETATION
REVIEW € REVIEW
SEATURTLE I MANGROVE
REVIEW REVIEW