HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO (MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i_ O<i�!
Permit Number:
I
Planning and 1Jevelapment Services wilding Permit Application
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:
Legal Description:
Property Tax 1D #:
Site Plan Name:
Project Name:
Setbacks Front` Back, _ Right Side:
--- 8 Left Side:
DETAILED DESCRIPTION OF WORK:
C ls.�k r<
CONSTRU11
CTION INFORMATION:
i111:151trona wor to e eI orme un ert is permit—c
C�HVAC Gas Tank Gas Piping
ectric Plumbing OSprinklers
Total Sq. Ft of Construction-
Lot No.
Block No.
L JShutters Windows/Doors
E]Generator ❑ Roof
S Ft. of First Floor: _
Cost of Construction: $ Utilities:Sewer 0 Septic
OW LESSEE:
CONTRACTOR:
Name r
Name:
Address: _V(X Company;
City: State: �_ Addr.
Zip Code: Fax:
City.,
Phone No.
Zip Codef
E-Mail: Phone No.
Fill in fee simple Title Holder on next page { if different E-Mail: t t ni Cif
from the Owner listed above)
State or County License
If value of construction is $2500 or more, a RECORDED Notice Of Carnmencement is required.
Building Height:
Irv,,
�State _
Fax:
1 t;Inc t
-r-OK3111CR/ GIV[aiNtrK: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: . Phone:
I certify that no work or installation has commenced prior to the issuance of a permit,
which is in conflict with any representation that
Associatio t rules bylaws or the permit
that build
o�rr proh bit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply,
c
In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work
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: 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.
ignature of Owner/ Lessee/Agent 4inAure of4Cont_ractor/Ucens_eHold—er $
STATE OF FLORID k STATE OF FLORI
COUNTY OF . U ] COUNTY OF _
The r oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thls5 ay of L ham_ 20 Irby this day of - U'd�, ZO ' b
�or_0,
{Name of per cknowle gin g� (Name of e n acknawled i
2
ature of Notary Public- State of Florida )
of Not* Ptflic- State of Florida }
Personally Known �JOR Produced Identificati '"i!k'!�%,, Personal) Known
o� y �/� OR Produced identification
Type of Identification Produced Type of Identification Produced �..
'
Commission Nv. (Seal), •,�•;:� Commission No: �- G'�'I 25�- (Seal) +�'��'"�o*`�
PhilIif� �1Mill
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATECOUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
COM PL.ETE
INITIALS I I I I I
Property Identification
Parcel ID: 001552
Identification 9: 716020024596
Account Status: Open
Location: 18 REFORMA LN
City: Saint Lucie County
Business Name: Shaver,
George III
Business Type: 7160 - Sp Lks
ABA: Sttaver, George III
#1
Contact: George Shaver III
State Code: 814190 - Mobile
Home Attachments
Ownership Current Values
Shaver, George III Market Value:
18 Reforma Ln $1,347.00
Fort Pierce, FL Exemption Value:
34952 $1,347.00
Taxable Value:
$0.00
Return Received:
Not Yet Received
Penalty: None
Download TRIM
PDFI
Exemptions
Grant Exemption Exemption Description Exemption
Year Code Value
Tangible Personal
2008 TPPX Property Exemption $1,347.00
Asset Group and Value
Asset
Value
MH Awnings
$54.00
Asset
Value
MH Carport
$209.00
Asset
Value
MH CentraiAC
$240.00
3.OT
Asset
Value
F-LE,CTRICIAL RISER ]PLAN
NOT TO SCALE
Underground
O Overhead
Grour dhig Electrode Conductor Size
❑ #6
#4
❑ #2
❑ Other
CONSTRUCTION TYPE:
O COMMercial
Residenitial
�O Mobile Home
New Installation
O Old Installation
I. Size Service: /Oo
2. Canductar Size; _
3.a. Meter Mahe: yes J
b. Meter Can only.
%
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61,S 2 flor A I I� J� }
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