HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONryrusT BE cOMPLETED FOR AppLtcATtoN TO BE ACCEPTEDI\[Permit Number:
Building Permit Application
Commercial Residentia I V
Planning and Development Services
Building ond Code Regulotion Division
2j00 Virginia Avenue, Fort pierce FL 34gg2
Phone: (7721462-1,553 Fax: (772) 462-t578
PERMIT APPLICATION FOR: To Setect from dropbox, ctick here
PROPOSED IN PROVEM ENT LOCATION ;
Property Tax lD #:
Site Plan Name:
Lot No.
Block No,
Project Name:
Setbacks Front Back:
---
Right Side:Left Side:
D!TA|LED DESCRTPTTON OF WORK:
ona
UHVAC _
D6n,
Gas Tank
Plu m bingtr
under thisltr
permtt -
Gas Piping
Sp rin kle rs
applv:
Sh utters
Generator
Windows/Doors
Roof
n
U
Total Sq. Ft of Constructiqn: _ Sq. Ft. of First Floor:
cost of construction, s 3,lW ,,,,,,,".",8 r"-"1 El";
CONTRACTOR:
Name:
State or County LicenseE
lf value of construction it SZSOO o
Building Height:
Com pa ny:
Address:'14.
citv:\-i'l( -I' l,_
zip codei:1C
Phone lio.'' 1r-li,
CONSTRUCTION I N FORMATION :
OWNER/LESSEE:
city:KJCJT*y\F[^@ 5131s;
Zip Code: i1 4{431 rax:
PhoneNo, \+re-€lG
E-Mail: f ) \ q f'nl)SrUn0 ( gCtA\ .
Fill in fee simple Title Holder on Vext page ( if different
from the Owner listed above)
Legal Description:
E-Mail: ( ltrL tl1 r'.ih I ni(,1.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City:State
zip:Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:
Zip:.
State:
Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
7ip:Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
zip:Pho ne:
owNER/ CONTRACTOR AFFIDVIT: application is hereby made to obtain a permit to do the work and instailation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.. [ucie County.makes no representation that is granting a permit will authorize the permit holder to build the subiect structurewhlch ls ln contllct with any applicable Home Owners Association rules, bvlaws or and covenants that mav restrict dr orohibit suchstructure. Please consult With your Home Owners Association and review'your deed for any resfriitions vitriih may applt -
ln consideration of the granting of this requested permit, ldo hereby agree that lwill, 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 pr:ols, fences, walls, signs, screen rooms and accessory uses to another non-residential use
..WARNING TO OWNER: YOUR FAILURE TO RECORD A frIOTICE OF COMMEIUCEMENT MAY RESULT IN YOUR PAYTNG
TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCE}IENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE F!RsT |NSPECTION. tF yOU TNTEND TO OBTATN FINANCING, CONSULT
WITH YOUR 98 Al\IAfrORrUEy BEFORE RECORDTNG YOUR NpTtCE OF
bf Ownefl-essee/Contractor as Agent for Owner
STATE OF FLORIDA.
Loururv-or -.<I.\rfE
Type of ldentification
Produced
ature of Notary Public
Name of person ma(i
!-n-at u re of Co ntra cto r/Li ce n s e H o I d e r
STATE OF FIORIOA .
couNrY oF o+.L\r \f .
The
th is
ature of Notary Public- State
Personally Known 6^produced ldentification
Name of person qakJng statement.
Type of ldentificationProduced-
commission rrro, G G 4 a@?S- 1Seat1
FRONT
COUNTER
ZONING
REVIEW
REVIEWS SUPERVISOR
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETED
,,
ins{4ment wap acknowledged $efore me
oi H(4tlyt- , zoj!\by
Nicole Yizzare
From:
Sent:
To:
Subject:
Nicole Yizzare
Monday, August 9,20213:03 PM
Nicole Yizzare
print
Property lclentifi ca ti cr:
Owner
' - l:
Legal Description
Current Values
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