HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; 2 — J& zozo Permit Number:
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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
PERMIT APPLICATION FOR:.5
Address:
Commercial Residential
Property Tax ID#:
Site Plan Name:
Project Name:
Lot No.
Block No.
i TAILE'D'D.ESCRhPTI'O'N OF
New Electrical Meter Second Electrical Meter
CON'STRU'CTI'ON' I°N�FO,R,MATQN+ - - -
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ ?q 90.00
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
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Name�jak�C�1�e,�;P---
Address: Aue
City: =/ L State: L
Zip Code: 3q Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name._, 3 a I,"
Company:, tx-I--e'ri biY .-Ac
Address:
City: (_ Stater
Zip Code: Fax:
Fax:
Phone No -66e 0 0
E -Mail fYZTUt�Qe;fr L'a>a-a
State or County License C" •i � (nbCr�`�`�
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION- UEN LAW INFOJIMIXt-ION:
DESi SNERIENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: - Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY. Not Applicable
Name:
Name:
Address:
Address:
City:.
City:
Zip: Phone:
Zip: - Phone:
OWNER/ CONTRACTOR A-FFIDVIT-. 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 is ' suance of a permit.
St. Lucie County makes no representation that is granting apermit 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 Co -des 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 lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature fOwner/ Lesse /Contractor as Agent for Owner
Signature of C&tractor/Liceie Hoider_
STATE OF FLORIDA
COUNT/ OF
STATE OF FLORIDA
COUNTY OF _-PT-
The forgo. instrument was acknowledged before me
this /0 TZ of
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The for ping instruent was acknowledge ; d before me
/0day"'Qlf 'z-":?;bv
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this 20
Name of perfso�npakffing statement
person
ame o person making statement
e onally Known OR Produced Identification
�a
Per Cona y Known 070__roduced Identification
T e of Identification
roduced/
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Ty e Identiffeaftion
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REVIEWS
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REVIEW
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REVIEW
DATE
RECEIVED
DATE
LCOMPLETED
Rev. 8/2/17
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619 WILLOWS AVE.
13
14
12 11 10
OPENING
SIZE
1
168 X 63
2
36 X 26
3
74 X 50
4
37 X 38
5
37 X 38
6
74 X 38
7
37 X 38
15
75X38
OPENING
SIZE
8
37 X 38
9
37X51
10
53 X 51
11
53 X 51
12
53 X 51
13
74 X 38
14
37 X 38
15
75X38