HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MU3 BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5- /�� Permit Number:do JW
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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 I/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
'PROPOSED IMPROVEMENT LOCATION;
Address: j 1,� C&
Legal Description: a("6f Ii i C9 t- ( g " � -�-f� -,JF11Q2& uh,-' o
Property Tax ID#: L440etn -x(73 ' 00'5-!> '000-i Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Pr-w� �e
CONSTRUCTION"INFORMATION. .
Additional work to b e nerformed under this permit-c ec a appy:
HVAC Gas Tank Gas Piping _Shutters 12�windows/Doors
Electric 0 Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ � l�-� • O d Utilities: Sewer ESeptic Building Height: 0'(J
OWNERAESS.EE , : , CONTRACTOR
Name"-Thom,pson , r_o 9�l .�(rc,
�[ t?� Name:
Address: ti 5 99 W SWU� C 1 Company: A'►'I&Y W" 4LIyli &AM C'iAYA 660 '
City: o�, m 0-d:� j State:JR�- Address: 2,n�1 5 E d Ta✓1 'JT
Zip Code:3 "Fa'x: City: S Uodn k- State: FL_
PhoneNo. 41�_3_&d Y�797 Zip Code: 1 Fax: 1-1 to
E-Mail: Phone No. o? 3_qs(pcc
Fill in fee simple Title Holder on next page(if different E-Mail: nCri
from the Owner listed above) State or County License: WC C®1)1 0l b4
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
� 505 ` 0
SU,PPLl NTAL CONSTRUCTION 1-1814 11M INFORMATIOIV:
DESIGNS ENGINEER: Not Appilimble MORTGAGE COMPANY: �Not Applicable
Name; Name:
Address: Address:
City: State: City: State:
zip: Phone; Zip: Phone:
FEE SIMPLE TITLE HOLDER: �Not App(:cable BONDING COMPANY: _potApplicable
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 Count makes no representation that is granting a permit will authoriza the ermit holder^to build the subject structure
which is in con ict with aHyl applicable dome Ctwriars Association rui ,3iytaws r a ior
oovenants that may re ict or prahlblt such
structure.Please consult w th your Horne Owners Association and revvii your c�ae any restrictions A may apply.
in consideration of the granting of this raquested pe�mlt,,i do hereby agree that I will,In all respects,perform the work
In accordance with the approved plans,the Florida Buliding Codes and SL Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structuras,swimming pools,fences,walls,'stgns,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]obsite
before the first Inspection.-if you intend to obtain financing,consult with lender or an attorney before
-commericine work or reaording vouMotIce!of Commencement.
Si re of Owner/Agent/fess ature of ntractor/Licens Holder
STATE OFF STATE OF FI.ORMA
+COUNTY OF COUNTY OF
The f oing instru en wa acknowledged efare the The f oing Inst ent was acknowledged before me
this day af�' 20 1' by xhis day of� 20-it by
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tka Expires Ce/161.2018 OOMO12016
(Sign tura ry Public State of Florida) isi atureNa ary Public-State of Florida)
Perso by Known OR Produced Identification Personalty itno n ,,OR Produced identillmdon
Type of Iden cation Produced Type of identification Produced
Commission No. (Seal) Commission No. (Seal)
RMsed 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
PATE
COMPLETE.
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