HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFOIMUST B COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ( Permit Number:
Building Permit Application
s
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
y,. Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
.�.
K , a
��P{tOPOSED�IMPROUE�/I�ENT
T.'.,i�%m��+-s:`r��", k 7 3 n !��, y e � /s> kr'a. i�'4 ,.�ts.��' �r a a �'• t za 2
I�. Address:
..2G'3 1.12-"Ve.S Aid M- Y%S n Beach 'r-C 3L q S--�
Legal Description: 0-e-fi'1-e.S _,Slated INC.. A COndro- Sec-k�o Al 11 wpco aro'g
eyss_) I)20-2X410. ShaR-e iN Common btmp,-"_- S
I, Property Tax ID#: 4 50 of- SCA - 0 Zl 541 - 000" S Lot No.
Site Plan Name: Block No.
t. Project Name:
j Setbacks Front Back: Right Side: Left Side:
r �> ^� i e �r vr' �, ys1' 4 h � Y c a. ��"+ ,�s}'':s ,tt a d*t� 1RGf,%• :, tt � X k,.. s �� t"
RLT aILED DESCRIPTION' FUUORK
tR L a h
1 ,s-4.,<<.0 ..�.�t..�`'.�,, j °.�
4 � �
{
Additional work to be3nerformed under this permit-check all apply:
E:1HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
FlElectric El Plumbing ❑Sprinklers 12 Generator Roof Roof pitch
Total Sq. Ft of Construction:_ ��3 S . Ft.of First Floor:
i` Cost of Construction:$ � 00 Utilities:cnSewer ElSeptic Building Height:
,,rr r�T�Name 3,QyC. P_ 6 hca P—T Name: '.mil) 0 __Pj\.YL-
Address: o9_Gg Qt. Ak!s ck Company:SOTI,L I_�F-1Q) ;J g�(ST-evn.s
I'. City: S2x�Se.n R> aC&) State:GL Address:_3a.04 SG iL.')OLki U G4 Ate
Zip Code: 344 C(S Fax: City: Ste' ,)1A.'fi State: FL
Phone No. g�O~120 30 Zip Code:y341��- Fax:�'��-���- C3
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:Q 1?� �12+OO�.I)'la§)IS-V Yns I, C-1"'
from the Owner listed above) State or County License: CCC k 3.30
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Jyy
i`•
I
L SUPPLEMENTAL CONSTRUCTION`L'EN`LAW INFORMATION
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: ?C Not Applicable
Name: Name:
Address: Address:
i City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
II 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.
he 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
jWARNING 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
commencin work or,P69rding you_rNotigpof CoMmencement.
l
Signat of Owner/Lessee/C acto e r Owner rTATE
of Contra !cens er
` TATE OF FL ID A
COUNTY OF d OF
Th fo oing ins m t was acknowledged before me The r mg ins m t was acknowledged before me
' thi —day of 20� by this y o Q t .20 by
Name of person making statement Name of person making statement
! Personally Known _OR Produced Identification Personally Known OR Produced Identification
�
I` Type of Identification Type of Identification
Produced Produced
0
l_ (Signature of Notary Pu ic- tate of Florida) (Signature of Notary Pu is State of Florida)
I.
Commission No. (Seal) Commission No. (Seal)
I *4
,Pe•.��'. BONNIE LOVIT BONN�Eo oe
'714AIR ,,.. Y CO a
REVIEWS FRONT 1VGBXPI E � 21
R7 ZcP NS VEGETATION �i1fTE l�/IAN
COUNTERLERZV�E�--REWEW EW REVIEW �IEW VIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
G