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HomeMy WebLinkAboutBuilding permit applicationALL APPLICCA LE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED Date: 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 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: r ( �r '\ Legal Description: i�i(r n„� YI(�Qj ��() dW IC Property Tax ID ##: (313— 0a,-6604-000_3 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: "DETAILED DESCRIPTION OF WORK` Main AIC 54-S�Wjf40W( neW Lth()©,x a.s br►, I� SfreK AIC S JS-gM (dt4- , 8 k r0 VtMk- RUCTION INFORMATION: wor to e e orme un er t is permit - c e a app y: VHVAC❑Gas Gas Tank Piping _ Shutters Lt Windows/Doors Electric Plumbing Sprinklers Generator ❑_ Roof Total Sq. Ft of Construction: 5. Ft. of First Floor: Cost of Construction:$ q000.00 Utilities:SewernSeptic Building Height: OWNER/LESSEE: CONTRACTOR: Name 0 G Name: L Address: L4500 IZPL�LOC)(1(Y� �1' Company: UOvt6 "'r, tlli'Y f4in 1�1na £ HP.� ifGr�. City CU({7 p1PYCL State: � Address: 5105` PrTLCrri�likl� Fet�b�'--Fi.L, ” Zip Code: 301,61 Fax: City_ laf&IPref-c& State: R, Phone NOIIL-4QQ . 3� Zip Code: _'3" EFax: -77.7-- 4 jp((! - 3TS-7 E -Mail: /5� Phone No. -".I- 1p(-411-1 ^s 4-10 Fill in fee simple Title Holder on next page ( if different E -Mail: hD�/i nA hp0. C- ( from the Owner listed above) 7fre State or County License: %` Aa,181-3( $ If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 'L a y SUPPLEMENTALCONMUMON N.I Name: Address:Name: SATE € F FLORIDA '4, Luk City- State: Zip: s City: state. 3Phone: [I 1, Name:Name: --Pot Applicable III Addrew.■ _„ �1 thisS40day of .2QI R by WW -F kyle. Zip:_ Phone: om € ItUR IFID 17-Appkationis hereby mate-toobtanapernottoBotheworkandinatat3ationasindicatad- I eeNify thatno work or insiaflabon has commenced prior m the issuance of a permit St. Lucie County �makes no representation shat is granting a permitwiii authorise the perms€ hoiderto h the subject sFsocture which is in corltlsttwifin any applicable Home Owners Association rules, bylaws or am covenants that may restrict or prohibit sud i structure. Please consult with your Home Owners Assomuo?t and review your deed for anyres[au'swns Which may apply. In consideration of the griming of this requested permit, I do hereby agree that I will, in all respects, perform the work I in accordance with the approved plan, the Fbrbda BIildmg Codes and St. tude County Amendments. The following buflding permit applications are exempt from undergoing a full concurrency revievin room additions, f accessory structures, swlinming pooh fences, wags, ssgrrs, screen ii113rIi5 and accessory uses to another non-resfderrtiad use WARNING TO Your iaffure to Record a Notice of Commencement- s dray result in your paw twice for irrmprovements to your propert j A Notice of Cors me iceme}-it must be recorded and posted on the iobsite before the first inspection. if you intend to obtain financing, consult wiitlr lender or an attorney before €omr-riencfne work or recordine vour Noticer of FnmmencemPnt_ Rev. 812117 Signature Oa Owner/ Les -2 ContraOO Agent for %mer Signature Of CuntractorAkense Holder i SATE € F FLORIDA '4, Luk STATE OF FLORIDA � COUNTYOF COUNTYOF The forgoing srstnrmentwas admowledged before me The forgoing hrsttument was admawriedged before me M&t4k this St-dayof_ hkrjyCK .ZqU by thisS40day of .2QI R by WW -F kyle. WJwl F 13D ie Name of tement name of persn aling sta went Personally Known OR Produced Idealilimfton — Personally Known V OR Produced identification ..,Type of Idenfificabon Type of Identi rcatfon Proddu�ucedd,, Produced e (Signature of Notary -= State, ofHoridaj (Signature of Nota bic-StateofFloridaI r Commission b9 PHRISTINE . dwELL Csmmisd N,pa ." CHRISTINE J. CONPEW) ` tf""' e°. '-= Notary Public -State okFlorida Notary Public - State of Florida ` ' ��,' Commission # GG 017839 w. ° = Commission # GG 017839 - RI'VllWS r. ' ,Fo"•; ` ` it u Tonal o PLANS '` de t h _ any s GROVE COUNTER REUIEW7 REVIEW REVIEW REVIEW REVIEW l DATE RECEIVED DATE '1 COMPLEr€D Rev. 812117