HomeMy WebLinkAboutSUBMITTED PAPERSAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
SCANNED Permit Number:
Date: BY
St. Lucie County
-
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 virginio Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR:
Address:
Legal Description:
iv
7�/cam !Z V Do - aco-- ) _ Lot No.
Property Tax ID #: r
ate✓ SL•E S 2 sf�� �` Lis s r
Block No.
Site Plan Name: iQly
Project Name:
Setbacks Front Back: Right Side: Left Side-
dffj'lon-51 Work to be perrormed under tnis permit— air-, O" Shutters
_ as Tank AGas Piping Windows/Doors
Mechanical � — _
Electric _, Plumbing ,_ Sprinklers — Generator _ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ % 3 % 2 Qr-1
T,
City:
Sq. Ft. of First Floor:
Utilities: _Sewer- _Septic. Building Height: .
State:cL
Zip Code: 3VIM Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next- page ( if different
from the owner listed above)
Name: e
Company: M P n i a r
Address:
City:
state:.
Zip Code: 3 y9 J00 Fax• 2 7 L f: 9011
Phone No: 2 )a -03 •�9S/G
E-Mail:- of
State or County License: 0•? Q?��7
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNEKIt "'"'"•
Name;
Address state:
City: phone;..
FEE SIMPLE TITLE HOLDER:
Not Applicable
Name:
Address.
City: Phone:
Zip:
blia
MORTGAGE COMPANY. _
Not App.
Name:
Address: state:
City: Phone*.
Zip:
Not Appl►cable
BONDING COMPANY:
Name:
Address: -
City: Zip: Phone:
---------------
is hereby made 30 obtain.a permit to do the work•and installation as indicated:
OWNER/
CONTRACLOR AFFIDVIT. Application
I certify that no work or installation has commenced prior to the issuance of a permit. restrict or prohibit such
tion rules, bylaws or an covenants
t is ion which mayapplY•
resentation that is granting a permit will authorize.ta permit holder atto. build the subject structure..
St. Lucie,Count makes no rep 6cabie Home Owners Assoc► . d Perform
the work
which is �n con iet nsu ith any, applicable' agree that 1 will, m all respects; p
structure. Please consult -With your Home Owned Aermital'do hereby g your dee .or an
f this request P Amendments.
Inconsideration of the granting o Tans, the Florida auilding Codes and St: Lucie -County. review: room additions,
in accordance with the approved p
ermit applications are exempt from undergoing El full concurrenu esto another non-residential use
The following building p. our a in twice for
accessory structures; swimming pools, fences, walls,signs, screen rooms and accessory-
res!uses
O OWNER: Your failure to Record a Notice of me t mus b .record d atnd post d en b fore
WARNING T A Notice of Comment
imp v�ments to your .property. _ c suit I lender or an attorn .y ; .
.,errinn_ if you Intend to obtain finan;�}.
STATE OF'F-E
COUNTY OF.
The for .ping instrument was acknowledged before me
this day of Qv L • 20 / ,bY
(Name di'sperson acknowiedgin )
(Sig' ature of Notary Public Stat. Florida)
Personally Known OR Produced Identification.
Type of Identification Produced
Commission No. Y ,�l%4410 MICHAEL
STATEZ7F'ELORID�T
COUNTY.OF - -
The.f,o,.r�,QQing instru��erit was acknowledged before me
this G dayof /'' ✓ f a T , 26 VOY
Personally Known OR Produced Identification
Type:of Identification Produced
No. j
f, MICHAEL MILEY
ex"Kea July o, dot NS VEG
REVIEWS FRONT Z � SLI "' Rli
COUNTER REVIEW;
oQ�
ST. LUCIE COUNTY
BUILDING DIVISION
REMWED
FOR OOMP�E
REVIEWED �
j_ DATE �y
pL E NU pERhnl IT
mUsT or
KMPT ON JOB OR
NO INSPECTION W11-I, RE WiAhLl.. .
• �V
BOARD OF
COUNTY
COMMISSIONERS
i
II
'O 1�
to �� �A11
�A� PIPING �CH�MATIC
[All IA*j
TANK SIZE: GALS.
APPLICANCE—'iYPEISIZE
Al
A2
.A3
A4
A5 --
A6
PLANNING & DEVELOPMENT
SERVICES DEPARTMENT
Building and Code Regulation
Division
BTU
BTU
ya GG� BTU
BTU
BTU
BTU
PIPING LENGTH.& SIZE
31v, INCH DIA.
L9 F � FT.
L29. FT.
INCH DIA.
L3 1=T.
INCH DIA.
L4 FT.
t INCH=DIA.
L5 FT.
— INCH. DIA.
L6 FT.
INCH DIA.
L7 FT.
- INCH DIA..
L8 FT.
—INCH DIA.
L9 FT.
INCH DIA.
L90 FT.
— INCH DIA.
L11 FT.
INCH DIA:
t12 T.
INCH DIA.
(PIPE :SIZE WAS TAKEN FROM
THE 2090 FBC FUEL GAS CQDE -
TABLE 402 r. y 07 _ y�
CHR1S DLADOVSKY, District No: I • TOD MOWERY, District No. 2 • PAULA A. LE\VIS, District No. 3 • rRANN1E HUT�CI I uc N. Di'oyctNo. 4 • KIM JOHNSON, District N
CountyAdminislrator -- Faye W. Outlaw. MPA, ICMA-CM Website:
2300 Virginia Avenue - Fort Pierce, FL. 34982-.5652
Phone (772) 462-2822 FAX (772) 462-1681
OFFICE USE ONLY:
DATE FILED:
REVISION FEE:
1
FA
3.
4.
Sc
f,
st B y' '0 � ®�
PERMIT # 4Cj�
1�0$ sty
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGIU
2300 VIRGINIA A
FORT PIERCE, FL 3
(772) 462-1553 FAX (7
APPLICATION FOR BUILD
PROJECT INF
LOCATION/SITE
ADDRESS: 39 t ) S
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #:
BUSINESS NAME:.
QUALIFIERS NAME:
ADDRESS: I
CITY: Irz, 7 Puae.
PHONE (DAYTIME): -?g-2
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE:
5. ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
Revised 07/22/2014
ST. LUCIE COUNTY CERT. #:
STATE:
FAX:
STATE:
STATE:
FAX:
FAX:
ZIP:
ZIP:
ZIP:
Y
,wm,-r
)v OK- ® .
-ST LUCIE COUNl'y L
BUILDING DIVISION
REVIEWED
FOES ®16AP ANCE
REVIEWED E
DATE
PLAN AND ER , IT
MUST BE KEPT ON JOB OR
NO INSPECTION WILL BE MADE
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