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HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (" Date: Y.' Permit Number: �©l 'p3�w Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 y� 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: 1 rN I 5 .r- na_ f 1 I Z c Legal Description: V 1 nq� ee�:) Y V I Qmb c R f k R Lb+( CT_ 14Q6"N6 n f.951 Property Tax ID#: 4 J o of s(]( 0C,�)L� 6Cn (42 Lot No. Site Plan Name: Block No. Project Name: 01.QpM0_n Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: 1 a6Lo l G(Ime, lshnL /205 ID )1f11/_ 2- CONSTRUCTION INFORM' ION: Additional wor<toe nertormed under tispermit—check all appy: HVAC 0 Gas Tank Gas Piping _Shutters ❑Windows/Doors 11 Electric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction:$ �c/ Utilities:cnSewer Septic Building Height: OWN ERAESSEE: CONTRACTOR: Name (10 Q Q Name: F ra,0 a C Address: 3` 41 6, —I-- (CZ . i Cm opany:e +������� ', 5596 City-, State: Address: r/��,/,jn J� �diI C Zip Code ��! Fax: Cit y` �t/ l ) Statilef` : __ PhoneNo. `o��CJ ' l�d Zip Code: `14q.6 '� F�: �� D E-Mail: Phone No. 11 `VT — (D Fill in fee simple Title Holder on next page(if different E-Mail: CLb u-eS�2.DD o ` from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLE MENTAL�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, 1 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 o�Owner/Lessee/Agent Signat re of C, ntractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OFMartin COUNTY OFManin The forgoing instrument was acknowledged before me The forgoing instrument was acknowledgedbeforeme Mthis day of�C;�.�l 20 1�by this -t day of �1 tl-n20 0� by Frank Fitzpatrick aAgent Frank Fitzpatrick as contractor (Name of person acknowledging) (Name of person acknowledging) ignature of Notary Public-State of Florida) (Si ature Notary Public-State of Florida ) Personally Known xx OR Produced Identification Personally Known xx OR Produced Identification Type of Identification Produced Type of Identification Produced Commission o.� e�otsr9 Pew state of Commission OXY Po n Nota Public State of Flo�ial Jacqueline A Pascarello . Jacqueline A Pascarello ommission FF 899682 c a My Commission FF 899682 9 94 Fro Expires 08122/2019 Revised 0 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS