HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : Permit Number:
S 4 L
Building Permit Application
Planning cind Development Services
Building and Code Regulation Division.
0 Virginia Avenue,, Fort Pierce FL 34982
Phone: (772) 4 -1 5 Pax: 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT
Address:
Commercial Residential
LOCATION:
f-')-P4- 3aw
Property Tax I D #a. tj 0' evo-w- I�
Site Plan Name:
Project Name: L nc)'�
DETAILED DESCRIPTION OF WORK:
)PD) 0 (t,K;-�li, Yi CL!b 4'iVaS
"4"
Nw�
Second Elec�rica Meter
CONSTRUCTION INFORMATION: A&A 0.
'izn gea__�_,
1�al aAt-
YZ6
Nr �r 1P . e-
Additional work to be performed under this permit —check all that apply:
Mechanics! � GasTank � Gas Piping _Shutters
I ectric Numbing Sprinklers� Generator
1 k�
Lot No.
Block No.
11 r o/Doors Pond
Roof Pitch
� Total Sq. Ft of Construction,: 5q Ll Sq, Ft. of First Hoar:
Cosh of Construction: $ �. �S� - Utilities: � Sewer � Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
cz1L42.
Name.
Name
Address:_—U,000 j � d Company: rt%
City: ^ 3LY)/1 _ .�n State: Address:L�ti I
Zip Code: � � f "� fax: %� City: JILLIL�"% .zG�c.. Stater
Phone N(64
6 �'� zEp Cede: 9yFax- �'�-2���'—d�:�;.�_
Phone Na
E-Mail:
Fill in fee simple Title Haider on next page if different E-Mail SLc_iA
from the Owner fisted above; 3mt"r County License
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required .
1# value of HAV[ is $7.,500 or more, a RECORDED Notice of commencement 9s required,
4
M
SUPPLEMENTAL CONSTRUCTION LIEN LAW I.NFORMATION:---
DESIGN ER/ENGI NEER: Not Applicable J'-M0 GAGE COMPANY:
Name:
Address:
citylk State:
zip: Phone—
FEE SIMPLE TITLE HOLDER:
Not Applicable
Name -
Add ress:
City; . . . .....
p= Phone.
� Not Applicable
a :
,y
Add ress:
City: State..
Zip: Phone:
BONDING COMPANY:
Name:
Address...
City%4
{
i P Phone:
Not Applicable
OWNER/ CONTRACTOR AFFApplication is hereby rude to obtain a permit
I certify that no work or installation has commenced prior to the issuance
t} Lucie iCounty � a r� representation that i granting apermi i � � `i r �n'11 authorize the rm t holder to build the subject structure
rct with any applicable able Home Owners Association rules la
tru ctur'�, ���a�� ��� It rt� ��r � � or a r� covena rat thata restrict or prohibit such
n r cation and revsyour deed for any restrictions wh rch may apply.
In consideration of the granting of'this r nested 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
The following building permit applications are exempt from undergoing rgorncon
currency fly �currncreview: room additions.,accessary structures{ swimming pools* fences, walls* signs., screen rooms and accessory uses to
another non-residential use
WARNING TO OWNER: Your fa -lure to Record a Notice of Commencement may result 40 ;&
in paying twice for
improvements to your properly. A Notice of Commencement mush be, recorded in the public records of St.
Lucre County and posted on the jobsite before the first inspection. Ify'olu intend too ain financing, consult
with lende r an attorn re comme�cin work yr recordin our Native ofmencemer�t.
nature of wrier/ Lessee/Contractor as Agent for owner
STATE Of FLORIDp
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
A��hysical PrNotarization
�� rr��r�
tl-is - day of 00 by
Name of person making statement.
Personally Known R Produced Identification
Type of Identification
Produced
ature of
vtary Public- Stake of Florida )
-Wr co
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REVIEWS
DATE
RECEIVED
DATE
COMPLETED
e .
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G�S
`� � ga�ded Th Budge
FRONT �r 00 NING SUPERVISOR
COUNTER REVIEW REVIEW
F
Signature of Contra ctor/License Holder
STATE OF FLORIDA
COUNTY OF z,,qlil�,
Sw9rn to (or a'Iff'[1-med) and subscribed before me of
I hysical Presence or Online Notarization
i O b
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(§Wa-ture df Notary Pubic- State of Florida
Commission
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