HomeMy WebLinkAboutBuilding Permit Application 1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Numb r:
' ". EIVED
MAY 2 0 ?019
•
-_ Building Permit Appli County, Permitting
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: S�
V _
PROPOSED`fMPRROVEMENT LOCATION:
Address: gAV 1-cliIJ Tru 60 9 d1lu of R JI/17Y&
Property Tax ID#: 3.322 Y01 001 000 7 Lot No.
Site Plan Name: / Block No.
Project Name:'
DETAI't.ED
DESCRIPTION 2OF WORK:
'=%)1C"( ObM
CONSTRUCTION INFORMATION: r
Additional work to Ile performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping Shutters -Windows/Doors
_Electric _Plumbing- _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$&3 d !coq o Utilities: _Sewer _Septic Building Height:
01NNER/LESSEE: : CONTRACTOR: ,.
Name Name: P L
Addres : 60 Company: — Z:7
City: State._ Address:
Zip Code: '771 Fax: City: — l _ State:
Phone No. V0J-)6V Sq Zip Code: v 0 Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail .z�
from the Owner listed above) State or County License —r JJg
If value of construction is$2500 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.
DESIGNER/ENGINEER: Not Applicable -MORTGAGE COMPANY• "'° Not Applicable
Name: Name:
Address Address
Clty State: Clty :State:
� .
ZI Phone Zi Ph
px - p; one.
•
FEE SI MPlE'..TITLE`HOLDER _Not Appbcable BONDING COMPANY __Not Applicable
Nanie - Name:
Address , Address
City
lip." Phone
77777OWNER/CONTRACTOR,,AFFIDVIT.Application is hereby made to obtain a permit to do the work and installationas indicated.'
d i certify that no work or installation has commenced_prior to the issuance of a permit._
St.Lucle'Count Crake'no representation that is granting a ppermit wili aut or`ize th','ermit-holder;ta b'uild'the sub]ecC structure
i which is in con ict wit any applicable Home Owners Associatlonrules,bylaws or'andpcovenant sthat may restrict or prohibit such `
structure.Please consult with your Home owners Association and review-your deed forany restrictions which may°apply.
In consideratio i'df the granting of this requested=permit,I do hereby agree that i will;in all respects,perform the work'
in accordance with:theapproved plans,the Fiorlda�Buildin' gCdesanStWce6ty.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 O"1111IER; `1'OUR�FAiLURE°TO RECORD A NOTICE OVCOMM •
° EwCEMENT MAY RESULT 1.N, .:YOUR PAYING
TWICE Fdk IKPROVEMENTS TO .YOUR.PROPERTY. A ISIOTiCE OF CONNENCEMiENT.NUSf BE ktb6RD;ED Af06D"
OM THE JOB SITE BEFORE THE,FIRST INSPECTiOM, IF You-INTEND.TO OwAw FINAN011d,`CONS4JiLT
O WLENDER ATtORNEY•BEFORE RECORDING YOUR.NOTICE OF COMMENCEMENT."
Sig ure of owner/ seeJContmctor` entfor.Owner.° Sig- re ortna or ens Holder
' STATE OF FLORIDA STATEOF FEAR .
COUNTY OF: COUNTY OF" � `y
The foigoing•instrument was acnowiedged before me The forgoing instruii�Wtas�ajn�owl, dged before me
i this day�4,f 2Q� by °this
2day of
26 by' x
i- Name of person making statement Q o Q r3 Name,of person;rri kingstatement o w
_ :.. �.,
m N
r.t r
Personally Knon OR]rroduced identifi.
'—m n' Personally Knovn� QI{°Produced id�ntificatio " w
'Type identification � 4 :T e of.Idgn ' cat*o qh
Produced �' ti`
� duc�d �,t�.�-V r�rr
o x.c a
sii 'a, m
(Signature of Notary Public State of Florida) , . �. ure o€Notary Publie State of Fiondaa) `
Comrnission NQ, (Sear" +,
Commission No �� (Seal)
s
t
REl11EWS °�` ,.FRONT ZONING ''� � s � �.,:. �,. ..,. u� ..
PLANS VEGETATION SEA TURTLEMANGROVE
COUNTER REVIEW t°REVIEW . REVIEW R IIE)N REVIEW REVIEW
DATE
"RECEIVEt7 e
DATE= •
COMPLETED y'.,
e -
y