HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (6(/— � 6
Date: / �' % �• / �. Permit Number:
iiRz 11, iG NOY 17 2016
Building Permit Application SCANNED
Planning and Development Services BY
Building and Code Regulation Division 1e COUII
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
PROPOSED IMPROVEMENT'LOCATION:
Description: / 4 /I r.-rnA) 6 dA/ Ai 0�6 -0r Lo % /J
ID q:
Site Plan Name:
Project Name:
Front/00 Back:
Right Side: /7R-
Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF,WORK " '"",
l'�yST/GdeT yeu/ el-; S + 1 f ..� 3 WI r z ri�rti XIT-4p �
CONSTRUCTION INFORMATION";, 7
Aaartio iworxtooe ertormea unaertmspermit—cnecxan rid- iy:
HVAC GGaasTank ❑Gas Piping _tters Windows/Doors
Electric LJ Plumbing ❑Sprink s ❑Generator Roof Roof pitch
Total Sq. Ft of Construction: 3 3 S7 SqI Ft. of First Floor: �35 %
Cost of Construction: $ ��v Utilities: []Sewer Septic Building Height: T/7i
OWNER/LESSEE
CONTNT
RACTOR
Name 4/ /4t-1rJ,va49 r«a
a'e Fi
as
Address: SU fig G%
Comn�Dq
A
City: o/Li Si Lvr�F. Stater/
Zip Code: 39 8( Fax:
Phone No. ✓%-%Z 619 316
Address: #yDo -n/ 71P /LW
,/�
City:
Zip Code: 35" / Fax:
Phone No. 2 S- 7 J
Stater
E-Mail: 10,977-( //9�pd � G/I%l9/� rip/!
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: �cBy%/4y/- �J LDiJ
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State or County License: i /Ae, / & �;—v'/
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II If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. II
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(Sl1PPLEMENTAI CONSTRUCTION' LIEN !AW INFOI'fvIATION ,r
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DESIGNER/ENGINE� R:
j Name: /1�l c3// FA✓X..
Not Applicable
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MORTGAGE COMPANY:
Name: GsTFn/6Ph/
Not Applicable
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Address: s o "L
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Address: 3S� 5. I&Alxl l)
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City: ego
72
Zip: 37940 Phone: 2hy
State:_
SDo3s
City: Lone wodn
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State: G %
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IFEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Pddress:
Address:
City:
City:
ip: Phone:
Zip: Phone:
certify that no work or installation has commenced prior to the issuance of a permit.
Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
rich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
vcture. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
consideration of the granting of this requested permit, 1 do hereby agree that I will, in all respects, perform the work
accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
e following building permit applications are exempt from undergoing a full concurrency review: room additions,
cessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
NG TO OWNER: Your failure to Record a Notice of Commencement may
�ments to your property. A Notice of Commencement must be r or
the fjr�l inspectjon. If you intend to obtain financing, consult w' ler
as
OF Fl.
1'Y OF
forgoing instruMent was acknowledged before
_a day of 20 / bby
OLD,90
person acknowledging
It in your paying twice for
and posted on the jobsite
or an attorney before
iTE OF FLORIDA
JNTY OF o
f/o�rgoing instL��Ln� e)n�t was acknowledged before me 2g
{:Fl day of —�-�� 20�k by m
Yr-
person acknowledging)
(Signature of Notary �Olic-State of Florida )
nally Known J OR Produced Identification _ Personally Known / OR Produced Identification
of Identification Produced Type of Identification Produced
Commission No.
Revised 07/15/2014
(Seal)
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
R VIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
I
COMPLETE
4 I
INITIALS
OFFICE USE ONLY:
DATE FD.ED:
REVISION FEE:
2.
3.
4.
NAME:
ADDRESS:
CITY:
PHONE:
5. ARCHITECT/
NAME:
ADDRESS:
CITY:
PHONE (DAY
Revised 07222014
PERMIT# �k!- 03 1.4
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION SC $NNE®
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 St Lucie
(772) 462-1553 FAX (772) 462-1578COU11 t y
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE /�
ADDRESS: ,iBeU Z' /✓/ & "5- /,/"z � � �c�✓lG�l 3 7 �D 7
32,/1 -7o/— 001,7 �Ooo/i
DETAILED DESCRIPTION OF PROJECT
REVISIONS: / j
i
i //_ /7.n �/L �,��jF./Le �i `��/,v/ldads �.r✓ /1'//�✓�
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS: ��
CITY:
PHONE (DAYTIME): 7-7 7-
OWNER/BUILDER. INFORMATION:
INFORMATION:
COUNTY CERT. #:
STATE:
FAX:
STATE:
=7#
ST. LUCIE COUNTY
BUILDING DIVISION
REVIEWED
FOR C F NCE
REVIEWED BY�
DATE
PLANS AND PERMIT
MUST BE KEPT ON 409 Ofl
NO INSPECTION WILL 62 MAH