HomeMy WebLinkAboutBuilding permit appII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
Imo" Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential V/
Phone: (772) 462• :553 Fax: (772) 462-1578 Commercial
PERMIT TYPE: 9kraqy-
address: �� Lot No.�Q�._
Property Tax ID #:
Site Plan Name: –
Project Name:
Block No. —
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank _ Gas Piping , Shutters
Electric _ Plumbing — Sprinklers _ Generator
Total Sq. F` or Constru-+ion: _ ((D X
Sq. Ft. of First Floor: _
Cost of Construction: $ Jr • Utilities: — Sewer Septic
Name_:
Address: 541Lbee
Citi: f State:
k_ PrGrt�e.
Zip Code:. bLM45L Fax:
Phone No._T1�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
— Windows/Doors
Roof __ Pitch
Building Height:
Name: G
Company: , ' � . �,r„ ' {..� p�gWx,dL ]�A �etl5fi►'�R.
�D
ooC'
Address: 110 13 'fornak°",�I�
City:
,l�... ��..ln.. f3,D/r State:_6L
�i�mwn.
Zip Code: '3ag31 Fax:
Phone No _7_7a-337'
E-Mail,q)4A:M
State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
if value of HVAC is r7,S00 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
— N7Applic7ableMORGETGACOMPANY: Not Applicable
Name:ame:
Address:
ddress: State:City:
_
ty:
p: Phone:
Phone
Zip: ---_.-------- ------.
------
FEF .SIMPLE TITLE HOLDER:
Not Applicable BONDING COMPANY: Not Applicable
Name: __._
Name:
Address -
Address:
City:
City: —
Zip: _ Phone:
Zip. Phone:
�WIVEP,/ CONTRACTOR AFFIDVIT: Application is hereby 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.
Lucia, l:o�r tv rr:ak�.� no representation that is granting a permit will au laws e the permit holder at build the subject structure
nriiich is n conflict with any applicable Home Owners Assoaatron rules, bylaws or and covenants that may restrict
may apply. such
Structure Pleas? con�.:rlt with your Home Owners Association and review your deed for any restrictions which may a I
Incoconsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
n accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
he following building permit applications are exempt from undergoing a full concurrency review: room additions,
c; ��•,or•; struci -1rES, sw'rnrning pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING 'If0 OWNER: YOUR FAILURE TO RECORD A NOTICE Of COMMENCEMENT MAY RESULT IN YOUR PAYING
9 rv9 :E rFOFt LM�R0�IEMENTS TO YOUR PROPERTY. A iNOTIi E OF COMMENCEMENT MUST BE RECORDED AND
POSTEDONTIIE JOB SITE BEFORE THE FIRST INSPECTIOI'aI. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
W,JTH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:'
Aner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
'� £ ::F FLCr.46�;P , STATL OF FLORID,&A')
UNTY�;I tlUidllf OF
ISfproing ii st t.i ar C Was dCRr GWieogi d uefc,re me
day of_. 20Z by
of person making
I,y Kn?wr, _- OR Produced Identification
ident-ficat c-1 /1
atiire of No y Public State ofFlorida ;
Comrnission Nov.�,��,! (Seal)
REVIEWSI FRONT I ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RE _EIVED
DATE
COMPLIFTED
I ile fIp`i going uastl a env was acknowledged before me
�4�.�-
this _ day of 20�' by
Name of person making statement.
K
0
U.
�n
Personally Known OR Produced Identification
type of identification
iProduced--_. `
PLANS REVIEW I V EVIEWON I SEA EV EWLE MR VIEWVE