HomeMy WebLinkAboutBuilding Permit Package ALL APPLICABLE INFO MUST BE OMPLETED FOR APPLICATION TO BE ACCEPTED
�ZI � t v�Date: _ Permit Number:
s
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 n
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED IMPROVEMENT LOCATION:
Address: m i` I� CQ� _ 1�..�
Legal Description:_
Property Tax ID#: Lot No.
Site Plan Name: � �� ' 1 E � �lj` .6 i —�, Block No.
Project Name:
Setbacks Front Back- Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
%l
CONSTRUCTION INFORMATION:
Additional work to benerformed un ert is permit—c ec a apply:
OHVAC Gas Tank Gas Piping _Shutters Windows/Doors
C;re"'ct�ric ❑ Plumbing Sprinklers Generator ❑�Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ !_ Utilities In Sewer 1:1 Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Nam Y'\ , Name: .:.I -�s:� n
Addr aC _ Company:
City: , - C State:9`i Addrress:'. r.-1
Zip Code:f LKA J Fax: City�- ) :t 1 Statef"
Phone No.1 Zip Code1i Fax --
E-Mail: Phone No.'-ri£ ' a r• F.:o t'
Fill in fee simple Title Holder on next page( if different E-Mail r k"q, ire€vA ( `o fq _,t � '
from the Owner listed above) State or County License {__ I �::�, { !LIO
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
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.
I 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.
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LfNDER OR AN.4kTTORNEY BEFORE RECORDING YOUR N ICE OF C MMENCEM Te"
Sid of Owner essee/Contractor as Agent for Owner Siffa ure of Contractor/License Holder
STATE OF FLORJPA i STATE OF FLORIDA,-
COUNTY OFk A `i COUNTY OF
'The f�r oing instr m nt was-acknowledged before me The Nr ing ins%r ent was acknowledged before me
this ,s 4.1y of `� 20�by this � ay of 20 by
Name of person ma in state Name ak of person m ng statement.
Personally Known QR Produced Identification Personally Known�R Produced Identification
Type of Identification Type of Identification
Produced Produced AL
Nicole MCMI
Nicole 'UZ
Conm,IIGG35GG355075Not
(Signature of Notary Public rim 8;l�Qy, (Signatureof Notary Public ® Tht11 AM
Sol +ad Thal Aaron
Commission Na. _ (Seal) Commission No. C (Sea!)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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"You'll Know The Price....Before We Start"
ELECTRICAL RISER PLAN
NR TO SCALE
Residential
�JC Mobile
NO CommercialOverhead
.l
underground
jtib ' Service Size
Atxi Conductor size evlp�
7tJa]� Meter 1D#
Meter Can
QJC Meter-Main-areaker
#4
#2 i2CPrti R6t7 4nZ(,U,,4 p LA"(=?Tfi 3 t J S
C3ITEOGE l2U$i C—,V,
pdo Power Kill Needed
No Meter Pull
'40 Cut at Weatherhead
Q Cut At Transformer
408 Farmers Market Road•Fort Pierce,Florida 34982
Martin. St.Lucie Indian River Fax
772-283-7529 772-878-3974 772-231-1866 772-468-8924