HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date• CO ' ! )!Q. Permit Number:to 4- 1 . . . .
.�
RECEIVED
Building Permit Application JUN 17 2019
Planning and Development Services
Building and Code Regulation Division Perm I tt i n gC a rt f e n t
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial e5heWie runty, FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: !C-4 in SS
Legal Description:
Property Tax 1D#: 001. Go Lot No.
Site Plan Name: L'�1)gm-(S 11 L4, �e S �(Y(,J��:.5 F Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
Ir F;-dvt,4- C (3 S
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CONSTRUCTION-INFORMATION
-Additional work to be performed under tispermit-check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric ElPlumbing Sprinklers FIGenerator Roof
Total Sq.Ft of Construction:/. L{�` S .Ft_of First Floor:
Cost of Construction:$ (o QC� Utilities: Sewer Septic Building Height:
OW 114WLESSEE CONTRACTOR:
Name Qg ve,19 f'd V Name: A. 4f
Address: Company: c r14�I/2
City: �State:P�_ Address: CO3 EC�, I
t c1l
ZIP Code: Fax: City: E"f f -Pi State; /C
Phone No. 7,� -^ .��--(1`� 5 ,� Zip Code:3 Lr(6'>- Fax: 7 7 a- VK/v FTF
E-Mail: /i i/ Phone No. _7 7�-�Lf(.I f—.5\3 6
Fill in fee simple Title Holder on next page(if different E-Mail: ce Ir' ��v CQd
from the Owner listed above) State or Coun 'cense:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
F
ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
Address:
Stater � State:
Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:- ' Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address- Address
Zip.- Phone: Zip: Phone:
I cert*that no i m*or Installation has commenced prior to the Issuance of a permit
St Lucie County malas no tion that is granting=atonal au rorize the permit holder to bind the subject structure
winch is in cornflttt wdh any applicable Home Owners dation or and emw ants that may restrict or prold such
structure.Please consult with yaur Home Owners Ammon and review your deed for any restric ions which may apply.
In consideration of the granting of this requested permit I do herebKagree that 1 wilt in all respects,perform the work
In accordance with the approved plans,the Florida BuUding Codes and St Lude County Amendments.
The followingbLinding permit applications are exempt from undergoing a full concurrency review:room additions„
accessory structures,swimming pools,fences,walls,slgr>%saeearoom"accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Comntemmi ent may result in your wAi*twice for
improvements to your prgperty.A Notice of Commencement must be recorded and-posted on the jobsite
op before the first inspection.If you intend to obtain finan cing,consult with lender or an attorney before
commendniz work or recording our Notice of Comm 'c
Signature of Owner/AgeW Leasee Sigtaature of ConntractoiA em Holder-
STATE OF FLORIDA STATE OF FLORIDA -
000NIY OF COUNTY OF
Theforgbingh9ftumern s aciotowlecW before me 7 ent acbnow by me
this�7 day - -20_+ by _
of (Mainebf f
Y
(%waun-
(Signature of NWP Pubik State of Florida Y (Signature of Noyry Public state of
Personally Known / OR Produced Identification Personally Known/' _OR Produced Identification
Type of IdaMcation Produced Type of Identification Produced
Commission No. ;4►�'s, AUDREY B. REY Commission N ••' !. AUDREY B.HUNp
:;. MMISSIO�3=17 ,': MY COMMISSION#GG 300817
EXPIRES:March 6,2023
EXPIRES:March 6,2023
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