HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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: Shutter
Legal Description: /�YNCia� V>l�/�G� ��L�� � f�11U►'% �""%3
Property Tax ID#: 1-1-Y) GLiy1)37" 066 0 Lot No.
Site Plan Name:_37_6"61 1Ji0 /« Block No.
Project Name: SRI I`JV-LF-y Lb l<-
Setbacks Front Back: Right Side: Left Side:
DET;AILED�DESC�IP��lON�O�WORK � z 2
s,k _`:.. r.,,� t.+ti.:vo-4 hc'"`fi, W L�Ss "',!Pa a'i,:o x} °,e„n '�' ✓,i v�r
CONSTI I N TI0 11 F.0 M N ('O1N � x
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Additional work to be nertormecl uncler this permit–check all t=appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 PlumbingOSprinklers ElGenerator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ ��C�rt Utilities. —Sewer[]Septic Building Height:
COI�TR�
Name Name: furl l _
Address: _NP4Company: IU'l t1 S i-ri�6"f)p- ,�/ia�CIZ 669f
City: StateAddress: dc)��l� 5_e %kLZ��Y/t) rj jrFr%
Zip Code: 461'1 Fax: City: -(�Gl�h S�LzN/� State:j��
Phone No.
45(o ( _15 (a Z.(0 Zip Code: J:3yiY Fax: 77.2-21\2-32V
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from"nthe Owner listed above) State or County License: ,9"6;�5
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION L'IE;NFLAIN INfORMATIOfV
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
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 wok-olvecording our Notice of Commenceme t.
Signature of Owner/ gent/Lessee Signature of Cont;dctor/Licen4 Holder
STATE OF FLORIDA STATE OF FLORIDA.
COUNTY OF y.(\Cxf\�r`" COUNTY OF '000-1-4 i r
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 5a day of T` \ 20 Eby this aday of {}(.\ 20_by
(Name of person acknowledging) (Name of person acknowledging)
Signa ure of Notary Public- to of Florida (Sign ture of o a ublic-State of Florida)
Personally Known a" 1%&oducg)fDl WN6fI�N Personally Known. e enti i
Type of Identificatio ip blit State of ort "�,P'1'��. J� NfVt Mf
yp o'n Type of Identiflcati Prod a ,"N
a��` Commission No.E 11123118 r *z Notary Pu A fFtoridda
42236
Commission No. '%''Fo c�°��° Vw ComWes&Expires Commission No. s ooh (�@tloyssion No.EE 8
Vjy Commission Expires 1112311
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS