HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABL INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED E7
Date: Permit Number: /
,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 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox; click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:Address: q 5-51 0 US w4 I F:'r - I ery-c, Ft-` 3�6gl
Legal Description: . OF l __Tfu9$Z_l O O rVJT' o Al C— -_5.q-rat AS
b F,� 7 Z a IJ 21 L*-l Yof FtA=T 0 A�i�'1 �'d 3 7
Property Tax ID#: �7 /6"' 6� ` -U�z y Lot No. /"
Site Plan Name: I'-v- WCAv't- vE 5*00 Block No.Project Name: AV\1 C-u,—' OPT Sf 9'i1,e— P S)DA
Setbacks Front Back: ';;� ° Right Side: r Left Side: 7
DETAILED DESCRIPTION OF WORK: FEWC C p4M" I T--
V►A C eu rx I ti� (je OAJ
(�'�0 befie- f r' SCE o'
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CONSTRUCTION INFORMATION:
Additional work to e nertormed under this permit-c ec all apply:
11HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
11 Electric El Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$�1v Cr0 Utilities: _Sewer OSeptic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name t- Name: 'b N
Address: Company: SE-*�Po I i)4T6-BOiLDEX-�S
City: t�f-tE State:__ Address: Q Q%)e�. 14��
Zip Code: 3L q � Fax: City: P State: C—
Phone No. Q 4�-L ;TFZip Code: Fax: t-J A
E-Mail' S® CC)4A Phone No. 77 Z- 5-7-7-ell b�-
Fill in fee simple Title Holder on next page(if different E-Mail: J 'F 0r'__t--LC1-- "111 .Caffl
from the Owner listed above) State or County License:C6C. 3
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER�EN�GINEER: _ of Applicable MORTGAGE COMPANY: J� Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
1 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 jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commericing work or recording your Notice of Commencement.
-�,Hr e. s
_Signature of Ow r/Less a/Agent arg ature of n a ens e Holder
STATE OF FLORIDA STATE O ORIDA
COUNTY OFF COUN F
The for ing instrument yvas acknowledged before me The for oing instrum nt as acknowledged before me
this day of�Y C`� 20 Eby this y of 20 by
(Name of person acknowledging) (Nam f person acknowledgin
(Signature o otary Public-State of Florida) (Signature of Notary lic-State of Florida)
Personally Known t/— OR Produced Identification ersonally Known OR Produced Identification
Type of Identification Produced Type of Id �41
ced
Commission No. ion I
r� 'Notary Public Stated Flodda ,.SPayr� ANGELAMHUFF
c �,� My Commission FF 932735 =• ; _ ; Commission#FF 234730
Revised 07/15/2014 'horn Expires 1Jos/2019 My Comm.Expires May 27,2019
Bonded throu h National Nota Assn."
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE N
COMPLETE I
rINMALS