HomeMy WebLinkAboutBuidling PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
DatL. 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 X"
PERMIT APPLICATION FOR:
Address: 7c -A-
Legal Description: L.,{
Property Tax ID #: I L}
Site Plan Name-
Project Name:
Setbacks Front Back:
clitional work to be pertormed unc
_Mechanical Gas Tank
Right Side: Left Side:
permit- cneck all that apply:
Gas Piping — Shutters
_ Electric �S Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ . 1 t 10 , GG
Name ty arv- r— 15
Address: 7Ga Q
City: FO (, A- F i Q r9? State:
Zip Code: 3 49� 1 Fax:
Phone No.
E-Mail:
Sq. Ft. of First Floor:
Utilities: `Sewer _Septic
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Block No.
Windows/Doors
_ Roof Pitch
Building Height:
Name: .,Q�Yki( I F g Kz, 'l'-
Company: r-%Qi QL
A, (Na
Address: /S /0 pcCQC
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City: A (3 state: �1{
Zip Code:
Phone No j - aiQ�- 0/ `�
E-Mail �. f"QC e I r
State or County License CFC-!
1A QQn-N
lz:An-go
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
_X_
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name-
Address:
Address:
City.
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
� Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name.,
Address-
Address:
City:
City:
Zip: Phone:
Zip-- Phone:
OWNER/ CONTRACTOR AFFIDVIT. Application is hereby mane to obtain a permit to do the work and installation as Indicated.
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 authailze thepermitholder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an covenants that may restrict or prohibttsuch
structure. Please consultuhth your Home Owners Association and review your deed for any restrictions which may apply.
In consideration ofthe 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 Building Codes and St Lucie Go unty Amendments.
The following building permit applications are exempt from undergoing a full concurrency review_ room additions,
accessary structures, swimming pools, fences, wails, 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 payingtwice for
improvements to your property. A Notice of Commencement music be recorded and posted on the jobsite
beforethefirst inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement. ,.
as Agent for Owner 15i6ffume of Contractor/license Holder
STATE OF FLORIDl STATE OF FLO A _
COUNTY OF -h �� i Qie � 1 COUNTY OF ,►�� ►,
The fore - g instru i s acknowledgeAbefore me The forgoing instrumen as acknowled"before me
this ay of G zfl by this 1 day of(? by
ame of person making statement `--- Name of person makingstatement.
PersonallyKnown-K OR Produced Identification
Type of Identification
REVIEWS
COMPLEi'ED
FRONT I ZONING I SUPERVISOR
COUNTER REVIEW REVIEW
Personally Known � OR Produced Identification
Type of Identification
lrj�"
{Signature Q �li�c �— lgKaZ'
• . Pamela Dyer -Hope
Commissio x My conWsswn zGGz zs$tg�alj
0,Wr
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW I REVIEW I REVIEW I REVIEW