HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO rST BE COMPLETEDS APPLICATION TO BE ACCEPTED
Date: `� J/ Permit Number: / v
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 X
PERMIT APPLICATION FOR: Gas tank (-
PR®P®SED IPR® EME'NTLAON
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Address: 15 Castle Court Fort Pierce FL 34949
Legal Description: Queens Cove unit 1 blk lot h
Property Tax ID#: 1414-701-0190-000-4 Lot No.H
Site Plan Name: Block No. 19
Project Name:
Setbacks Front Back: Right Side: Left Side:
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C®NSTRtJCTI®N IINF®0�/I�ATION �� ;x x! �, .' E
Additional wor toe e o under this permit,-c ec a app y:
HVAC _Gas Tank Gas Piping _Shutters O Windows/Doors
11 Electric O Plumbing OSprinklers O Generator Roof
Total Sq. Ft of Constructions: SFt. of First Floor:
Cost of Construction:$ 3595 od Utilities:]Sewer O Septic Building Height:
OWIUER/LE�SSEE ! iCONTRACTOR _
NRR .;
�.t� � �, ,. q, :. h
Name L°0M(.Lh r C`.✓ Name:
Address::J.5 Company: ;En efg.Z Cry 5
City: :rC ,p;, ;rc2 State:EL Address:•. bye 11JcJ' %�u��. S _
Zip,Code
.�l'l�l�I;' Fax:7. City: 'C'c S�._�• �G�.e State: �� L
Phone No. �1 �-LtLol - 1,390 Zip Code: '3`fy2go Fax:
E-Mail: Phone No. '77,2- - LTD-7- �fS�ly
Fill in fee simple Title Holder on next page(if different E-Mail: }ge)to,e,1 L P l-•�r� `ze heCZ
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPP.If lyENTwA'L CONSTRUCTION LIEN LAW INFORMATION:
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 work or recording our Notice of Commencement.
i
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_Signature of Owner/Lessee/Agent Signature of Co racto /License Holder
STATE OF FLORID STATE OF FLORID""COUNTY OF [ /Ie COUNTY OF <i- \I I cu`CZ
The ft�going instr ent w s acknowledge efore me The f going instrument was acknowledged before me
this R day of 20 by this day of /I{�Q�, 20I_by
(Name of rson acknowledging) (Name of p�son acknowledging)
(Sig ure of Notary P lic-§tat'ep Florida) (Si Kurd of Notary Public-S_tatdo(Aoriclti)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. w Notary P�g§)ate of Florida Commission No.
Antonia M Paula Note u i State of Florida
My Commission FF 191201
Antonia M Paula
M CommissiormxpiFes 02127420 9 C_'kn FF 191201
a A Expires 02127
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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