HomeMy WebLinkAboutBuilding Permit ApplicationJ`
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
tCOV� 'D AUG 04 2037
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
�P"ROPD IM�PR®1%ENIE i" L� CATI::"C)N}:'
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Address: \\a C 649,5y Ft Pie-rcie., E- .
Legal Description: Tnc an ji\(ec EAoAes Usvi--L-D3 QU,' 15 Lai I (MV4?391Io5)60.S-CAON
�o�.1�433.2v�
PropertyTax ID #: 3LlD ;1- 1o0Ll- 00-1- 000-a Lot No.1
Site Plan Name: Block No. 15
Project Name: ��eX� 1�GtJ�isi S
Setbacks
� �I • 1 I /
Iditional work to be
❑HVAC
❑ Electric
nertormed
under this permit — cneCk all mat apply:
Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors
Plumbing ❑Sprinklers ❑ Generator ❑ Roof
_
Total Sq. Ft of Construction:
ov
Cost of Construction: $ too o�.8$.
S Ft. of First Floor: _
Utilities: Sewer ❑ Septic
Building Height:
OU1/NE%LE�SSEE�:Sam I I
I�LLy
4 �I td F%
Name t^alen )" is
Name: RobertZrallack
Address: W;L E i a5�j 5�
Company: Solar Energy Systems
City: F-l' P Ie_+rc4 , State:
Address: 160 Smallwood Avenue
Zip Code: 3Nq 1 c;1 Fax:
City: Fort Pierce
State: FI
Phone No.
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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DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_
Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
Address:
Not Applicable
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 recorainR vour Notice OT (Ammencement.
_ Signature of Owne essee/Agent
)( 1Lt&JL=== s
Signature of Contr r/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF f5+ W u e— COUNTY OF �i WC; �e_
The for ing instrument was acknowledged before me
this fi day of ftLL wS 20 Lby
Robert Zrallck
(Name of person acknowledging)
The forgoing instrument was acknowledged before me
this 3 achy ofPcuQ V!5- ' 20 1-1 by
-10
Robert Zrallack
(Name of person acknowledging)
(Sign ture of Notary Public- State of Florida) (Sigl ature of Notary Public- State of Florida )
Personally Known n/ OR Produced Identi
Type of Identification Produced
FF9[ai 3? STATE OF FLORI[
Commission No.
1bomin#FF91213w7
hxpires 8/24/201
Revised 07/15/2014
Personally Known I/ OR Produc IdenVj&t ,lc_
Type of Identification Produced 010TARYPUSUG
MS,TLATE OF FLORIDA
Commission No. � m# FF912137
® Expires 8/24/2019
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