HomeMy WebLinkAboutBuilding PermitII APPLICABLE 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 TYPE:
Address: sag& l�1(�/i4°. �'-�� �' --
Property Tax ID #: 135 1 U� Lot No.��;Q__ _
Site Plan Name: ('O Block No.
Project Name: _
Additional work to be performed under this permit - check all that apply:
Mechanical _ Gas Tank
Electric _ Plumbing
Total Sq. F' of Consrru-tion: -1(0 )C :7
Cost of Construction: $ Ii s? 5 -..Ob
Gas Piping
_ Sprinklers
— Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof P tch
Utilities: _Sewer _Septic Building Height:
--
Name-
Ad d res
ame_Address: Sa4(k 1 rn_An. 7L
State: )�
Zip Code: Fax;
Phone No.
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: )nniL[lfI j-IlL9fe7p
Company: Mkk 96*91 of T-YeWrJ- TSA RectStcw «rte
Address: lip 3 TofhA,�l-��
City: tnll[M �, 176r .,Y PO-&C't. Stater
Zip Code: 3ag31 Fax: 3x--71-)``4� _
Phone No -7-7A- 1,57- J41"7O
E -Mail 'qLaas (a-) Y7Y Sf O�r1 eta --�'
State or County License Qq'�11
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is t7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name::
Address:
City: _
Zip: ---- – -- Phone—
FEF .SIMPLE TITLE HOLDER:
Name:
Address:
City:__
Zip:
ity:—
Zip: — Phone:_
Not Applicable
State
_—_ Not Applicable
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: _..... _ - Phone:
— Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:
Address -
City:_
Zip: —
Phone:
WNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
�uci<_ ;oil tv ir;akc--.s no representation that is granting a permit vviil auihorize the permit holder to build the subject structure
Rich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
ru+'ture Pieas � coni ult with your Home Owners Association and review your deed for any restrictions which may apply.
consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
ne following building permit applications are exempt from undergoing a full concurrency review: room additions,
c: or; stnu.t .lies, sw'rnrning 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 LMPROVEMENTS TO HOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
:COSTED ON T14E JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WIYH YOUR LENDER OR AN ATCORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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of Owner Lessee/Contractor as Agent for Owner Signature of Contractor�e Holder
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