HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE OMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit Number: 2, e��-�5ll
Date:
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-- - - - Building Permit Application
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Planning and Development Services 6Gd�
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: Poo
PROPOSED IMPROVEMENT LOCATION:
Address: S el r hn I
11 ��yy �/� -7
Property Tax ID #:13 LI '5 I - V Q � -f � O / Lot No.
Site Plan Name: Block No.
Project Name:
DETrA TD DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft Of Construction: l Sq. Ft. of First Floor:
�0"
Cost of Construction: $ % Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
GONTRACTOR:
Name Wke In'"Name:J
`�
f
Address: l
compan le -
City: / - State:
Address: i
City: Stater
Zip Code: Fax:
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Phone No._`7v }C a
Zip Code: 101, Kilf Fax:
E-Mail:
Phone No% % C7 ` O -Y% 7�
Fill in fee simple Title Holder.on next page ( if different
E-Mail
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State or County License 1+o 10000 3 - 1 (�
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMEN MAH C
DESIGNER/ENGINEER:
Name:
ON LIEN LA
_ Not Applicable
O TIO
MORTGAGE COMPANY: _ Not Applicable
Name:
'Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
-Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
vvr I.n/ a.vty t nm un mrriuvi i : Appacatlon Is nereoy mace to Main 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 authorize the permit holder to build the subject structure
which is in conflict 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, 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 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT-"
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signattrre of C n aq r/License Holder
STATE OF ELQ41 A
STATE OFF I
COUNTY OFS T) cQ
COUNTY OILiAL A
The r oing mst um nt was acknowledged before me
thi day of icC� 20�C�by
_1Jr__T
Th org ing ins m�enntt`w�ass acknowledged before me
thiday ofl, 20Dby
J
Name of person making statement. -
Name of person making statement.
PersonallyKnown OR Produced Identification
Personally Know OR Produced Identification
Y
Type of Identific tion
Type of Identific i
Produced -
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
nev. t/ i/ ly
e,,. - Notary Public State of Flonda .ram Notary Public State of Florida
UON DanyelJones DanyelJonea
s My commission GG 352016