HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE] FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ff �[
Date: I I Permit Number: 1� 1"(
Building Permit Application ISDLk7 0 `2713
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772) 462-1553 Fax: (7-72).462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: .(nCQRC1 "�V , �a-`1 es , ,N ..
Le al Description:\ Qe
Property Tax ID#::\Jyl:-'�� z)C�%1zoz:) iz)'-� Lot No.
Site Plan Name: --\V,e 51� y V-�Q__ QNX'—'K T�� CX e.Block No.
Project Name:y �CZJcy c'e< `T'C c�-`c��\p� t�_,
Setbacks . Front Back: Right Side: Left Side:, w� r
DETAILED DESCRIPTION OF WORK: ,
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CerNSTRUCTION INFORMATION: r-%r"W-,f `'"J '"`
ltlona wor to e e orme under this permit -check a. apply:
0HVAC - [, Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric 0 Plumbing. OSprinklers E Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $��
S . Ft. of First Floor:
Utilities: Sewer 1:1Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: ` w
Name _
Name:
Address: R O
Company:
City: ��51� S�� State: �•
Address:
Zip Code �yol �� Fax:
City:QC�L� �,._ �_ State: L
F.
Phone No.�C7a ���� - ��a:
Zip Code: �`i��� Fax:
E-Mail:
Phone o.k.a
Fill in fee simple Title Holder on.next page (if different
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from the Owner listed above)
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State or County License:Q.CQ.- Ohn3 `�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIONh
DESIGNER/ENGINEER. _ Not Applicable
.Name:.. S .C, . rie .
Address:\O
MORTGAGE COMPANY: _
Name:.
Address:
Not Applicable
.City: O State:
City:
State:
Zip:3yq"L2. Phone: -
Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
BONDING COMPANY:
'Not Applicable
Name:
Name:.
Address::
Address:
City: ..
City:
Zip: .. Phone:
Zip: Phone:
I certify that no work or installationhas. commenced prior to the. issuance of -a permit,
St..Lucie County makesno 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
commencing work -or recording our Notice of.Commencement.
Signature of Owner/ Agent/ Lessee ture of Contractor/License Holder
.STATE OF FLO DA STATE OF FLORIDA .
COUNTY OF . " v COUNTY OF fiLj.- 4
The for going inst ent was acknowledged before me The for oing ingtr ent was acknowledged before me'
this day of 20 14 by: this day of20_14 by .
(Name of person acknowledging) (Name of. person acknowledging )
(Signature of Notary Public- State of Florida) (Signature of Notary Public -State of Florida) .
Personally Known OR: Produced Identification Personally Known Produced Identification
Type of, Identification Prod uc04 Type of Identification Protcecl
aaun„ A.-my-l"s
}A Mr HUNTER�,STELLA M: HUNTE COm fission No. , (�ICommission No. �? . etart' Public -State of. lorlda .,yPublic -State o1.FlorWaCoMM sslon # FF 180 'Commbslon #► FF 1d055n xplres Jan 23,.20.19 xpl►fi Jan 28,.2019
Revised 07/15/2014 ���rnrou9ritVanonalnlctarygssn: �r•r'„+
:.REVIEWS. FRONT ZONING SUPERVISOR PLANS VEGETATION. SEATURTLE ' MANGROVE
COUNTER REVIEW REVIEW REVIEW, REVIEW REVIEW REVIEW .
DATE
.COMPLETE Jibl1
INITIALS