HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Dater 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
PR„C� ®SEDtilfipRUE11/1 ENT,LOCA !(JN' �a yryx
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Address: 59 1 Hiar G-man FL Pi'erG2. FL 3u ci g-
Legal Description: '1 35 No l &6 C'olilofS2-� 111 QO'g;Ig (2-1 !1 433c1E2�,i xF a 2-S r✓T (o(3,Tit N2.0oFT,
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Property Tax ID#: ?_Ll 4+4-cco1- 000'(o Lot No.
Site Plan Name: Block No.
Project Name: f't1 )-ria. GluaAaLpe- m e)si f l�unG�
Setbacks Front Back: f Right Side: Left Side:
®ETAIL-E® DESCRIPTI r.NBE WORtI<: n � Utt E � s��� � aw,��,
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Additional workto e e orme un ert ispermlc check apply:
❑HVAC Ei Gas Tank Gas Piping _Shutters Windows/Doors
❑ ❑
Electric El Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
1
Cost of Construction:$ �3�G I( . 0.� Utilities: _Sewer Septic Building Height:
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Name M o_ ii G.. Name: Robert Zrallack
Address: 5 Li 1 k c��rkmo-c-' `-6 Company: Solar Energy Systems
City: Ft P;e-rfo— State:FL Address: 160 Smallwood Avenue
Zip Code:SLickL1-1 Fax: City: Fort Pierce State: FI
Phone No. �112"332- oblolo Zip Code: 34982 Fax: 772-466-7937
E-Mail: Phone No. 772-464-2663
Fill in fee simple Title Holder on next page(if different E-Mail: vpsolarenergy@yahoo.com
from the Owner listed above) State or County License: CVC056637/9057
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SU LEMENTAL MNS rMRU 07TIION LIEN LAW INFORMATI®N:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicableil 4
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I 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
commencing work or recording our Notice of Commencement.
7 (711�FAJLL _ s
_Signature of Owner essee/Agent Signature of Contra or/LI nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5-�. Luc.e- COUNTY OF 54-. U rc
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this L44'day of Pre(-A 20 Eby this '-F 'day of 20 by
Robert Zrallck 1 Robert Zrallack
(Name of person acknowledging) (Name of person acknowledging)
/V b/ld�( i nature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida )
Personally Known OR Produced Identification Personally Known V, OR Produced Identification
Type of Identification Produced Marie Sarah Mu idype of Identification Produced Made Sarah Music
NOTARY PUBIL C s► NOTARY PUBLIC
Commission No.( -413-7 STATE OF FLO fEMmission No. FM I a 137 STATE OF FLORI
Comm#FF9121 7 Comm#FF912137
0
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE n
COMPLETE �C!—
INITIALS