HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO M COMPLETED FOR APPLICATION-TO BE ACCEPTED
Dater �c'26Permit 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: To Select from dropbox, click arrow at the end of line.
PROPOSED]MPROVE MENT,LOCATiON:.
Address: gay W00010D63 Dr. POrt- S+ Lode, EL 34g52
Legal Description: 1CK11(l1'1�S �I"3f (.-0.88 f4G) or X145" Q —
Property Tax ID#: 9915 JD1000 LJ QQO"3 Lot No. LI
Site Plan Name: Block No.
Project Name:. SQS ;SE31`lf15C71�)
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION. OF.WORK:
V-A A.,U (,I,Pje
CONSTRUCTION INFORMATION:
Additional worK to brtormed under this permit—check all appy:
nG
HVAC as Tank ❑Gas Piping Shutters- . Q Windows/Doors
Electric 0 Plumbing Sprinklers _E1 Generator Roof
Total Sq, Ft of Construction: Lig, OCk S . Ft.of First Floor: Zy
Cost of Construction:$ l�, Q(JO utilities: Sewer Septic Building Height: l2'
OWNER/L-ESSEE: CONTRACTOR: .
Name ,SQMe5 3-ohman Name: Z010er+ ZuCMVC)
Address: FAI4 WQ001( nd5 Dr. Company:.
City: p3rt �"�'- wrie State:EL Address: 201 g 1-bw� ��
Zip Code: 34x52._--- Fax:----- City::._thl-11f-a3ad - State: -
Phone No. Zip Code: 33020 Fax:
E-Mail: r0 1D1!1 0 V1(1sOI"1qqb@_VQI ffl- .C(. en Phone No. (cl5q) C17__Z" -7-7q5
Fill]n fee simple-Title Holder on next page(if different E-Mail: nares rP_ beJ V5Qi1 .nt?-I'
from the Owner listed above) State or County License:
If value of.construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTI N LIEN LAW INFORMATION-"
DESIGNER/ENGINEER: of Applicable MORTGAGE cOMPANY: Vot Applicable .
Name: Name:
Address: Address:
City:_ State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable .BONDING.COMPANY: _ of 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 mus recorded and posted on the jobsite
before the f' t inspection. If you intend to obtain financing, cot) ult h r or an attorney before
commen work or ecor ' our Notice of Commenceme .
�Ureoff Lessee/ " ent Si�hature of ZRIDA
ctor/License Holder
STATE OF
COUNTY OF 4�- COUNTY OF -- MIOQ I,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 9Nlt>�iOJ 20 Eby this�day of �N1 Ei r;6 .20 _Lrby
(Name of person acknow ging) (Name of person ackno ging)
(Signa of Notary Pr icic-State o Florida) (Sig of Notary P c State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of.ldentification Produced Type of Identification Pr,
R_7,y;�fiy-Pu¢� to of Florida Notary PµµbWlic�$�ate of Florida
Commission No. R- Commission No. Wiilliaml�Rf9Qec
m J f8 eCMy commission FF 196289
MCommission FF 196289 or R Expires 03/07/2019
Revised 07/15/2014
REVIEWS -.FRONT__- ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW -- - --REVIEW.. REVIEW REVIEW
DATE
COMPLETE '
INITIALS