HomeMy WebLinkAboutBuilding Permit Applicationi i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
� I _
Planning and Devefopment Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 452-1553 Fax: (772) 462-1578
PERMIT TYPE.,
Address:
Property Tax ID #:
Project Name:
Permit Number:
Building Permit Application
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Commercial Res+dential
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X
Additionsl work to
be performed under this
permit
— check all
that apply:
Mechanical
GasTank
I Gas
Piping
!Shutters
Electric
Total Sq. Ft of Construction:
cost of Construction:
Plumbing
Sprinklers
C
.� ,•� � Ti � � T F �-
i�
F
.�, PO
Windows/Doors
Generator Roof Pitch
q. Ft. of First Floor:
Utilities: ' Sewer _ Septic Building Height:
-LE's i
W
.O
f J h 1
Name
Address4,
P')- ,D �� State:
City:-1 12 #�
Fax:
zip code. 31
Phone N.
E-Mail:
Fill in simple Title Holder on nee
t page (if different
from the owner listed above)
1 F T 5
k C
i #
Name' s k
Company-,
rzo
Address: a'�%p
City: _TVL_
Zip Code-,
-3 !22 a;' Fax:
Phone N 5
i M a i I 1 01 kv jq Z I
State or License C6 C,
uct'Pon *s $2500 or morea RECORDED Notice of Commencement "is requked.
if value of constr I I I
if value of HVAC is $7,500 or more, a RECORDED Notice of COMMencement *is reqpired.
NOW
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State... 000f_ L
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DESIGNER/ENGINEER:
f Not Applicable
Name;
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: `Not Applicable
Name:
Address:
city.-
Zi P: Phone:
J. v
MORTGA�t ���.��n...
IVot App�ieabl�.�
Name:
Address: State:
City:
Zip: Phone:
_'� � rnnnceNY•
BONDING COMPANY*-
Not Applicable
rune:
Address:
City:
OWNER/CONTRACTOR AApplication is hereby mods to obtain a permit to do the wo
rk an d installation as indicated
I certify that no work or installation has commenced prior to the issuance of a permit.
-
t. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
that a restrict �� �r�����t u��
which i in con I ict with any applicable Horne Owners ssobation rules, bylaws or and covenant � f b may apply.
r r Association and reoew our deed for any restrictions which
structure, Please consult r�t� �u H�r�n� n�
In consideration of the granting of this requested permit, I do hereby agree that i will, in all respects, perform the rork
in accordance with the approved plans, the Florida Building Codes and St. Lucie county Amendments,
r t from undergoing a f0 concurrenc review: room additions,
The following building permit applications are exempt p � n �r�s�� �r��ia l use
r sw1rn mi n cols, fences, a 11s, sign s, screen roo rns and acces or-Y uses to another n
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
�" R Or"F1a� ���TroN. I1F YOU INTEND T OBTAIN FIN N INC IF CONSULT
POSTED On��� � � ��ETWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
"
yna R NOTICE OF
WITH OUR LENDIER OR AN ATTORNEY BEFORE RECOk-U'VOU
171 OUR LEN1111
0 VL
-signature of Ow
er/ lessee/Contractor as Agent for Owner � Signature of Contractor/License Holder
STATE OF FLORI �
COUNTY aF,I� _
The f Ding tin$trume t was acknowledge before me
thisdaY of �- ��by
Name of person making statement.
Personally Known � OR Pro
Type of Idnti ' tiaq►� _ �r
Produced!
Tsignat'urelof No ry Public- State of
Commission Na`�"�
� �Lqq
REVIEWS
DATE
RECEIVED
DATE
PLETFD
F
FRONT
COUNTER
.e
ONIQUE M. CARL01
, rtut,ic. State of F1(
1�1,y cornrn expires Dom. i0p
orida �
�Sealj
STATE OF fLQR1DA<:S
COUNTY OF
Ce
The f �gaing instrum nt was atknowled before me
this �1'day of Vim- Z0� by
NI/"l
.0 - "r W yf�-i
Name of person making statement.
T
Ir
22
naily Known R Produced Identification
of Iden tiff t i
iuced tke-40W
(Sjgn�ture'W Nota Public- 5t e
G %1
Commission No.
M NIQ E M. CARONI
Notary Public, State of `I
id A MMi ron 9�
y comma eqxres Dec.10,
(Seal)
NING
SUPERVISOR
P LANS
VEGETATION`
SEA
MANGROVE
R�
y
REVIEW
E IEW
'
REVIEW �
REVIEW