HomeMy WebLinkAboutBuilding Permit Application Nov 23 1511:53a P.1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Gate: � 023/ Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Vrginia Avenue,Fort Pierce FL 34952
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential V/1,
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
RROi'OSED.; M# Raf> M:€'+tT:
Address: 40, Cf 8 d L.1�k c+ 'i�d�►s 1��1`xw'�'
Legal Description:
Property Tax ID#: 6 o 0 - Lot No. l a t;-1?
Site Plan Name: Block No. f 3
Project Name:
Setbacks Front Back: Right Side: Left Side:
rPET-A-ILEDDESCMPT-1.. . ...... .... ... . .. . ..: . .:..... : . . ... ..
CONSTRi iCTI CSI I OFt 4ll}
Additional work to og-Dgrrormed under this perrn -check all thatapply:
❑HVAC ` G'as Tank Gas Piping E]Shutters Windows/Doors
Electric i:'SJ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction: $ 6.fid- �v Utilities Sewer Septic Building Height:
:.. ... : . QlVTRACTOR»
OVSIN�R/1SE;:.
Name --T-ArrjY: 1W'd+� Name: S0S'2VA/_ 14% Lir
Address:4,I&C W j'7t` Company: •.•�°s•`s J�Gcc... f3.}�f
City: A-7'^ 'i"J`"t e- State: J�G Address: /x942 14y .
Zip Code: 3 yr13-1 Fax: City: j0e�,f+mak State: ICC-
Phone No. Zip Code: 3 Y 9 S";4 Fax: ?7.2 33 S 02 666
E-Mail: Phone No. 77.2 -1-7 '7 346&
Fill in fee simple Title Holder on next page{if different E-Mai I et a r,!j se f vi
from the Owner listed above) State or County License: C-0-'e
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Nov 231511:53a p'2
SU.P:PLEENTAL-COUSTRU. M0N -IEN'%1A' IN -1
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 1 will,in ail 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.
:eSignature of Owner/Lessee nature of Contractor/ (cense r
STATE OF FLORIDA. STATE OF FLORIDA
COED NTY OF S'i<. -.. ,' COUNTY OF
The forgoing instrument was acknowledged More me The forgoing instrument was acknowledged before me
this�day of M6Y' T 20 !>-by this_ZJ day of Iib Inti k.6;20 1 S-by
t/ u
{Name gfh n ck gi (Name ersnn a ing
C
SigFly
i e of�rd6d " ry I )'d9 BfVICO.Wp,y`pp,Pefsnown (]R Produt's cation Personally Known OR Produced identification
Type on Produced ypeaEion Produced
Commission No. (Seal) Commission No. {Seal)
Revised 07115/2014
F
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS