HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ! Permit Number:
RECEIVED JUL 10106
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'here
!?RbPQSEQ tNPROUEMNT LO.rvAT10N
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Address: n er o-
Legal Description: ouktj New— Loa 20 (0e
Property Tax ID#:332 l-- 0Q2,— 1Q?,&'• VCV 5 Lot No. ,W
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
QETAILfD QESCRIPI'IOIIAF WORK'
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.CONSTRUCTION 11SIP EATIO.NF x
Additionalwar o e ,ej Orme un der this permit—check a apply:
HVAC I=.!Gas Tank FIGas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers F]Generator L '''�1 Roof
Total Sq.Ft of Construction: SQ.Ft.of First Floor:
Cost of Construction:$ 0 Utilities: Sewer Septic Building Height:
:t}WIER LESSEE
r C(3NTRACTOR°
Name riftird Name. IYluel 11
Address: 1031Company:
City: Rr4Letee— State: Address: flit° ew
Zip Code: Fax: City: . ��/��/DDelZ'� State.a& _
Phone No. 1707'1146-_ ��P Zip Code:��7`t'7r1 Fax:�I��.�Lf( gq�fS
E-Mail: Phone No. '71 -4(&5--/&
Fill in fee simple Title Holder on next page(if different E-Mail:
from the owner listed above) to or County License: n
If value of construction is$2500 or'more,a RECORDED Notice of Comme ment is required.
SUPPLEMENTAL CONSTRUCTION=-LIEN-'LAW-INFORMAT.10N.:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: T Not Applicable
Name: Name:
Address: Address:
City: State: City: ate:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY. Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone;
OWNER/CONTRACTOR AFFIDVIT'.Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Coun 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 your Notice of Commencement.
rigr?ah—um of Ownerl Agent/Lessee tSig ature of Contractor/License Holder
STATE OF FLORItA STATE OF FLORI�A
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COU OF COUNTY OF 34 t
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The ing instrurpenj was acknowledged before me The forgoing instr ment was acknowledged before me
Q,"day of P
thisVday*of t-JU-/Q- .20-Mby this/I 26EMby
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{Name of person acknowledging) (Name of person acknowledging)
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Type of Identificatio- d ; cff� Type of Identification Produ
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Commission No. i % 44,Commission No-
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED