HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
Commercial Residential -
PERMITTYPE:
6)mI 'Orion'— C-ba
PROPOSED IMPROVEMENT LOCATION:
Address: —7 5 5 I n
Property Tax ID #. -3 T �-A 59bDo-j o o0 �p Lot No.
Site Plan Name: Block No.
Project Name: rn e me
DETAILED DESCRIPTION OF WORK;
Of C�"S-- -�-P�
C-10c)d OlLan I q �-e ef- 51� d-c 3
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
✓Mechanical _ Gas Tank Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ Ul S , 5J' o
Sq. Ft. of First Floor. _
W in down/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWN ERAESSEE:
CONTRACTOR:
Name
Name: bip
lgt4
Address: �Ct 15Company:
{ e"T V! rL '%1�
City: State: A
Zip Code:303a LP Fax:
Phone No.
Address: ���
��
City:
Zip Cc t
Phone No 1
E-Mail (n .
State or County License
State: F-L
Fax: 50 j 711
c7o -
Y Lu - ( L-)ry1
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
It value ul WFMiIFUGilUn i5 ,SC7uu or more, a KtiVK1Jt:U NOLice oT Commencement is requiredt.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMI"NTAL CONSTRUCTION LIEN LAW INFORMATION:
IrIZ{ENGINEEi�; Not Applicable
MORTGAGE COMPANY: Nat Applicable
Name:
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:
rnAi1►ico / rrswoTn A rro%m A Pr. AiI1�
•-4.7 --tv . 47r -i vn rtrril,I V i i : Appiicavon is nere0y made 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 Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in can lict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, € 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 County Amendments.
The following building permit applications are exemptfrom 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 IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION- IF YOU INTEND TO OBTAIN (FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
- - a��
Signature of nW Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF aAtM BEACH
Signatu a o' ntractor/License Holder
STATE OF FLORIDA
COUNTY OFeA4m sEAcH
The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me
this day of- (Yl , ! zp by this � day of • 20_1 C! by
Name of person making statement. Name of person making statement.
Personally Known X OR Produced identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida
Commission No. FF976919 ntF Nor�ry Public State of Florid
s' ,� `:(Seil IleAli-Am rat
Arty Commission FF S7591p
'Fni •�4�� Expires 031300120
Personally Known )< OR Produced identification
Type of Identification
Produced
of Notary Public-'
�� PUe ovr Notary Pubic State of Florida
mission No, FF 976919 r `}Ali -Ararat
aK My Commiseion FF 97f313
y<eFfW Expires 03/3012020
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