HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
J.
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
.2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 462-1578
Commercial Residential ,
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of litre
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: R! r vis K_ a. � (�� ► -�-
Property Tax ID #: 5 OD -- (��d_ C Lot No.
Site Plan Mame: ! Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OFWORK:
CONSTRUCTION; INFORMATION:
Additional work to be z orrne un ert is permit -c
(HVAC F] Gas Tank ❑Gas Piping
L=1 Electricdumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ S� &�
OWNER/LESSEE:
a
LJ{ � Shutters Windows/Doors
T
LTJ Generator 11 Roof
S Ft. of First Floor:_
Utilities:[]Sewer I =.J Septic
Name r 'x h
Address:_„s1
City: P State= _rt/
Zip Code: 2H rtN ct _ Fax:
Phone No. 579 63
E -Mail:
Fill in fee simple Title Bolder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: _YI�seD4n Te
Building Height:
Company: tis Rirkb-knqLLG
Address -.Q Sc
City:_? s t, Ltj Cit State: FL_
Zip Code: 3q 9,5 2- Fax: 77 35- a68 0
Phone No. 11 - ;? 7 - 36 $
E-Mail:enesisurrb�cw se�ytc�@ arnot.n_c�+
State or County License: C_Vc kLA 2a -Lb
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conifict 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 5t. 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 Owner/
STATE OF FLORIDA, STATE OF FLORIDA
COUNTY OF �57- :`41 COUNTY OF S Z
The forgoing instrument was acknowl,dgeq before me
this _z�_ day of /► L&�CA 20 L
k by
(Name
Personally Known --I. OR Produced Identification
Commission NQ_
Revised 07/15/2014
The for oing instrument was acknowledged before me
this . . day of _ 4rCA- __ 20 14_ by
(Name
Personally Known ) OR Produced Identification
Prod
(Seal) I Commission No. (Seal)
REVIEWS
DATE
FRONT
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
HSEATURTLE
MANGROVECOUNTER
REVIEW
COMPLETE
INITIALS