HomeMy WebLinkAboutBuilding Permit Application AU-APRJC4BLEINFO M UST BECOM REM FORAPPLJWON TO BEACaFT®
Date: �' ��' Permit Number: / " 0���
•
Building Permit Application JUN 12 2015
Ranning and Development%rvices
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce R-34982
Phone: (772)462-1553 Fax (772)462-1578 Commerdal Pe§dential
POW ITAPPLJCATION FOR To Select from dropbox, click arrow at the end of line
PROPOSE IM PROVE1 FAIT LOCATION:
Address 3-2—k q '�Je\q l
Legal Description:
PropertyTaxlD#. Con Lot No.
Ste Ran Name: Block No.
Project Name:
S�Abacks Front Back: Rght Sde: Left Sde:
M7AILID DEMRIPTION OF WORK
CONSMC11ON INFORMATION:
i ion wor o Wormedunder is perms — a appy:
OHVAC LjGasTank []Gas Piping Shutters window Doors
0 Bedtric El Plumbing �rinklers [!Generator at0 Fbof
Total ckl. R of Construction: Sq. R.of First Floor:
Cost of Construction:$ :% o' Utilities _Sewer FlSeptic Building Height: i?J
OWN L CONTRACTOR
Name Name:
Address Company: u-
4tLa &
Qty: gate: `' o Address: 1 G I
Ap Oode: 114—t-'2- Fax City: �—
Phone No. Ap Code: ---'55 Fax Z�33C�1P4
E-Mail: Phone No. Z
Fill in fee simple Title Holder on next page(if different ELM ail: +(YK► Pu o Co
from the Ojvner listed above) State or County License:
If value of construction is$2500 or more,a FEDORD®Notice of Commencement is required.
SUPRSAENTALOONSR.1010N LIEI LAW INFUNAMON:
DESIGNERENGNEER Not Applicable MORTGAGEOOMPANY: of Applicable
Name: Name:
Address: Address:
City: State: Qty: Sate:
75 p: Phone: Zip: Phone:
FEESMPLETITLEHOLDER _Not Applicable BONDINGOOMPANY _ of Applicable
Name: Name:
Address: Address:
Qty: City:
Zip: Phone: Zp: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Countmakes no representation that is granting apermit vtjill authorize the permit holder to build the subject structure
which is In con t�with any applicable Home OwnersAssodation ru es,bylaws or and covenantsthat 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 1 will,in all respects,perform thework
in accordancewith the approved plans,the Florida Building Codes and St.Lucie County Amendments.
Thefollowing building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences;walls,signs,screen roomsand accessory usesto another non-residential use
WARNINGTO OWNS Your failure to Record a Notice of Commencement may r It in your paying twioe for
improvements to your property.A Notice of Commencement must be record and posted on the jobsite
before thefirst inkion. If you Intend to obtain financing, consult with led or an attorney before
commencin work . eoordin our Notice of Commencement.
9gnature of Owner/ t/Lessee 9gnature of Contr r License Holder
STATE OF FLOR D STATE OF FLO
ODUNTYOF r GOUNTYOF C
The for ing instrument was acknowledged b ore me The for oing instrument was acknowledged before me
thisyday of 1� 20 1 y this7day of _1-010 JC— 20_lq-by
/CG! YL/ X7 2 k9 SZ) (�Q� .tom /e'.0 S
(Name of person acknowledging) (Name of person acknowledging)
(9gn ure of Not I
Public-State of Florida) 9gnature of Notr Publio-Gate of Florida)
Personally Known_ OR�oed Icp�jggtp�,Gn Personally Known�ORProduced Identification
Type of Identification Produ* s 99616Type of Identification Produced
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Revised 07/15/2014XPIRES;February 23,2019
Commission No oP`O! 844"Budget Notary Services Commission No wY Pie QBQ M.ALONSO
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REVIEWS FRONT ZONING SJP6R/ISOR RANS VEGETATION SFATURTLE MANGROVE
COUNTER FB/IBN REVIBN REVIBN REVIEW FBABN REVIEW
DATE
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INITIALS