HomeMy WebLinkAboutBuilding PermitALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0
,i
- Building Permit Application
and Development t Services
PlannBuilding
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 IMS PROVEMENT LOCATION:
I
Address:020I I r(k R
Legal Description: 11 W� l k S SO�Ih £ 20
Property Tax ID #: 2 D 4� D3 ' 005 $ -.000- 0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
W�P, -For Lia : 3 to L tflox" 1� s lit SIC
51s�zwi 0)1"ks kw h .
CONSTRUCTION INFORMATION:
Iti a war to (e e Orme under this permit - ca appy:
Piping fi
HVAC L_t Gas Tank _Shutters�(windows/Doors
_ (❑Gas
Electric 0 Plumbing OSprinklers 0 Generator 0 Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ A%oo. 0o Utilities: L I Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
_
Name
Name: WchadF.
Address: tj Q1'f �I _
UU
Company: ( i 11� rtC.
-
h
City: �( Y State:
Address:510 A TL(,(YI ((�
City: fbrb— f erC& State: r-L
Zip Code: 3 Fax:
Phone No.
Zip Code: G 4q s I Fax:_7 1.2-- L4 (I -373-7
E-Mail:
Phone No.-M- 44alt-�41kl
Fill in fee simple We Holder on next page ( if different
E-Mail: (Pall-0 XJA no. On (Yl
State or County Licenste:
from the Owner listed above)
If value of construction is S2500 or more, a RECORDED Notice of Commencement is required.
CFOR A - : Application is hereby madeto obtain a pernutto do the work and installation as irulicated-
I certify that no work or installation has commenced prior to the issuance of a permit.
St lube County mak� no representation that Ssgi tinting a � will authorize the permit holder' to build the sob structure
' which is in with any applicable Home Owners Associat�r rari,, bylaws ora covenants that Tway restrict or prohitsit such
structure. Please consatt yo°Lr Mcrae Owners Asoaaioa and serew you deed for aayresttrictioras vA%tch may apply. g
In consideration of thegrantuag of this requested permit t do hereby agree that! wrrl, in all respects, perform the work g
in accurdance with the approved plans, the Florida &n-iding Codes and St Lucie County Amendments.
3 The following building permit applscat'ions are exempt from undergoing a illi mrmurreacy reuiewr mora additions,
accessory structures, swinau tsrg pools,%nces, wags, sgrrs screen moms and accessory uses another non -re iderrttal use
WARNINGTO Your fAure to Record a Notice of Cionigri in" result in your paw 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 tender or an attorney before
commend work or recording Notice of Commencernerrt. t
it a
e
Rev. 9/2117
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Type of Identification
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CFOR A - : Application is hereby madeto obtain a pernutto do the work and installation as irulicated-
I certify that no work or installation has commenced prior to the issuance of a permit.
St lube County mak� no representation that Ssgi tinting a � will authorize the permit holder' to build the sob structure
' which is in with any applicable Home Owners Associat�r rari,, bylaws ora covenants that Tway restrict or prohitsit such
structure. Please consatt yo°Lr Mcrae Owners Asoaaioa and serew you deed for aayresttrictioras vA%tch may apply. g
In consideration of thegrantuag of this requested permit t do hereby agree that! wrrl, in all respects, perform the work g
in accurdance with the approved plans, the Florida &n-iding Codes and St Lucie County Amendments.
3 The following building permit applscat'ions are exempt from undergoing a illi mrmurreacy reuiewr mora additions,
accessory structures, swinau tsrg pools,%nces, wags, sgrrs screen moms and accessory uses another non -re iderrttal use
WARNINGTO Your fAure to Record a Notice of Cionigri in" result in your paw 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 tender or an attorney before
commend work or recording Notice of Commencernerrt. t
it a
e
Rev. 9/2117
R{
5t3PPt€M�ALC£k €I>`i7(3AEil€IV[�Yli ilA�Ttf3N:
fdEP.�ENG6dEER: _ Nut A
PPi:catate TCA�E a(�Y _AfrstApalicabie
Name. Name:
Address. Ar3dress-
City_ State: -
Ztp: Phone Zip: Phone:
Phone- State.
FEE SIMPLE -€EF3.E t�EfiEi� y Not Applicable is C€B�IPE naot Appiic�bie
Name: Name.
Address:
�rafrrreoiCarrbactcs/Sicenseiioi�r
5rgo-atur'eoitlwnerl�sseelConiractnr hgent%r caner
i
STAT -[e $3i- FLORID t
53'A7°E OF FLORIDA,
Ct)l iNi'g OF �l � 12�
Ci�ilNTY flF u&
The for edgedbeforemeTherrtstrrrrrrawras
this�day282obyt3tisof�-su'G2tr�J
7acknaMedgedbeforema
hY
W""F7:s:g,�
�tie�.el � !cam
No me of person fervent
Name of persa - merit
Personally Known OR Produced Pnalucerl i$errtificafion
Persona8y Known LNr Produced ideriiifitaFirur
Type of ideritiiication
Type of Identification
Produced
Produced
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o ary Public S ate of Florida
Comrai�ien -' � ` Commission 7839
.; !on #
o;' My Comm. Ezpires Aug 21, 2D20
-,,�mm. Expir s Au 21, 2020
Bondetl Through National Notary Assn,
I pF Bonded through National Notary Assn.
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