HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
8 Haling Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential I�V/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:: -
Address: t S h -Fe
rr
Legal Description:..�� P�pt���
Property Tax ID ##:
Site Plan dame:
Project Name:
Setbacks Front
32 f - ?'a f- oo 1 -7 - Acsn -
Back: Right Side: Left Side:
DETAILED DES RIPTLON OF WORK:
CONSTRUCTION. INFORMATION:
❑HVAC
❑ Electric
Total Sq. Ft of
Cost of Constr
OWNERAESS
Name rd a
Address: -7 2 ((o
City: fir, � s�
Zip Code: _
Phone No.�
E-Maik
Fill in fee simple
from the owner I
M.G CI iVF Il It.0 uiruer [nis permit- cnecie aii apply:
Gas Tank E]Gas Piping _ Shutters
Xplumbing Sprinklers ❑ Generator
'action:
: $s
Sq. of First Floor: _
Utilities: []Sewer Septic
2 State:1L-
Fax:
e Holder on next {gage ( if different
2d above)
CONTRACTOR:
Name: `3seD4n TU
Lot No._
Block No.
0 Windows/Doors
ORoof
Building Height:
Company: QP, �.iOJAUM&ftq
Address:(9 tai_h)n Ave -
_
City: S U ek State: FL_
Zip Code: 3ggs2_ _..� Fax:D,680
Phone No. i-1 1- �27 -3G re
E -Mail: Genesis?VxVi10 * Serv_kc rn . ...._.orA
State or County License:
If value of constractis n is $2500 or more, a RECORDED Notice Of Commencement is required.
SUPPLEIVIENTAL CONSTRUCTION LIEN LAIN INFORMATION:
FRONT 7NTFREVIEW
COUNTERREVIEW
DESIGNER/ENG NEER; Not Applicable
MORTGAG E COMPANY:
Marne:
Not Applicable
Address:
Name:
City:
Address:
Zip:Phone: State:
City: State:
Zip: ph State:.
FEE SIMPLE TITL HOLDER. � Not Applicable
Name:
BONDING COMPANY: Not Applicable
^"
Address:
Name:
Address:
City:
City:
Zile: 'hone:
Zip: Phone:
I certify that no wo
St. Lucie County ma
which is in conflict ti
structure. Please co
In consideration of 1
in accordance with
The following buildi
accessory structure
WARNING TO 01
improvements tc
before the first it
commencinja wo
=Signature of Own
STATE OF FLORI
COUNTY OF
or installation has commenced prior to the issuance of a permit,
�s no representation that is granting a permit will authorize the permit holder to build the subject structure
th any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
suit with your Horne Owners Association and review your deed for any restrictions which may apply.
e granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
e approved plans, the Norida Building Codes and St. Lucie County Amendments.
Y. permit applications are exempt from undergoing a full concurrency review: room additions,
swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WER: Your failure to Record a Notice of Commencement may result in your paying twice for
your property. A Notice of Commencement must be recorded and posted on the jobsite
'pection. If you intend to obtain financing, consult with lender or an attorney before
or recording our Notice of Commencement_
The for oing instrument was acknowledged before me
this day of MA, -&A 20 L(r by
Personally Known OR produced Identificationf
F Y—P _eUf I i eori"Produced
Costtmisslon No. (Seal)
Revise. 07/15/2014
re of Contractor,
STATE OF FLORIDA
COUNTY OF S-�
The forgoing instrument was acknowledged before me
this f �_ day of,_,de&L" 20 14 by
(Name
Personally Known } OR Produced identihication
yp errbfimfion Produced
Commission No.
(Seal)
R
REVIEIr1iS
DATE
FRONT 7NTFREVIEW
COUNTERREVIEW
SUPERVISOR
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
COMPLETE
INITIALS'