HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE
II FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ( (`a7l[J Permit Number:
Building Permit Application
Planning and Development Services NOV 3 0 1015
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 IMPROVEMENT LOCATION:
Address: B V Foe f,,'enc e rz 35/f V
Legal Description: ))COQf La
Property Tax ID#: .34110- 5d8-6111 -600-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRI:PTI-ON 0
F WORK: _ --
)?.er—f-��,«oveex,J'f'L9 cao� �'A a�� 34 v ler�ayh�'.��G°.t
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CONSTRUCTION.IN FORMATION.
it
,,ional work toe performed under this permit-c ec a appy:
HVAC 11 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric O Plumbing O Sprinklers O Generator ZRoof
Total Sq.Ft of Construction: 16V S . Ft.of First Floor: 9db
Cost of Construction:$ 104- o Utilities:12 Sewer O Septic Building Height:
: .
OWNER/.LESSEE: . CONTRACTOR:
Name Icoyita„I Tx1ex 4'-pe 1 nc Name: '17,e,,64 �e, avl�°y
Address:til goo r'c vt :!-J a/ Company:-7-,re rC Cogj
City: -�dr4 A-0 r c e, State: Address:Mid' J✓ 13;hfwdre •r'��
Zip Code: 3N94?� Fax: City: porgy Sa:.n1� 1 vc,'g Stater
Phone No. 292Y Zip Code: 3glk!V Fax: 77Z-3y3-;?3 5f
E-Mail: Phone No. 7.72-370-g770
Fill in fee simple Title Holder on next page(if different E-Mail: T-1 /ley,47:,.4 LL-C 9D joto.•J, garn
from the Owner listed above) State or County License: tcc i 33 DG53
ff value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION,LIE SN 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.
_Signature of ner/Less t Signature of Cont r/License d
STATE OF FLORIDA STATE OF FLO�IDA
COUNTY OF Qy,1vC se COUNTY OF_ ,}c�,'ti� LvC.r'e
The forgoing instru ent was cknowledged before me The forgoing instrun,ent was cknowledged before me
this day of r 20 Eby this. day of !fr' 20 f,�by
epk1 e'rz�&
(Name of person acknowle in (Name of person ac I ging)
{Signature of No u ate of(•la .}••••••• �i (Signature o blic-State of Florio I1f11i���
e O;.\5g\oN EXp�9.• y ��P•����;;FtUNKF ���ri
Personally Kno OR Prod9c' i`ice ion •* Personally Known OR Prod ' `�••
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS