HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07/28/2015
Permit Number:
J ..
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
Address: 2300 Virginia Ave, Ft. Pierce, FL 34982
Legal Description: Please see attached
Property Tax ID p: 2416-504-0770-000-8
Site Plan Name: St. Lucie County Administration Building
Project Name: Department renovations
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION OF WORK:
Reconfiguration of approximately 4,000 sq. ft. of existing office space.
Lot No.
Block No.
I CONSTRUCTION INFORMATION: I
❑HVAC ❑ Gas Tank
❑✓ Electric 0 Plumbing
Total Sq. Ft of Construction: 4000 sq. ft.
Cost of Construction: $ $35,000.00
Piping ❑_Shutters ❑Windows/Doors
nklers ❑Generator ❑Roof
Ft. of First Floor: _
Utilities Sewer O Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name St. Lucie County Administration Building
Name: Owner / Builder
Address: 2300 Virginia Ave
Company:
City: Fort Pierce State: FIL
Zip Code: 34982 Fax: (772)462-1444
Phone No. 462-1432 - Jerry Flynn, Project Manager
Address:
City: State:_
Zip Code: Fax:
Phone No.
E-Mail:
E-Mail: flynng@stlucieco.org
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License:
If value of construction is $2SDD or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
DESIGNER/ENGINEER: ✓ Not Applicable
MORTGAGE COMPANY:
v Not Applicable
Name: NIA
Name: wA
Address:
Address:
City: State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
Not Applicable
Name: WA
Name: WA
Address:
Address:
City:
City:
Zip: Phone:
Zip_ Phone:
I certify that no work or installation has commenced prior to the
St. Lucie Count makes no representation that is granting a peCrmit ' I autholfze the permit holder to build the subject structure
which is in con Act with any applicable Home Owners Associatiob laws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Associatici a revie our deed for any restrictions which may apply.
Inconsideration of the granting of this requested permit,.] pb , reby a ' that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Buildir}gC sand tticie County Amendments.
The following building permit applications are exempt frbm un oink a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, scf n rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Cormencement 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
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF
The forgoing Instrument was acknowledged before me
this _ day of 20 _by
(Name of person acknowledging )
(Signature
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
Revised 07/15/2014
STATE OF FLORI�A
COUNTY OF /N -C
The for instrum t as acknowledged before me
this dng ay Of J & 20 15 by
(Name of person acknowledging )
NXaA�L�
of Notary Public- State of
Personally Known �@A P i-11114,ERILEY
Type of Identification Pr JOANN MARmmissian`^ ExpirCommission No.?
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