HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 3498.2
Phone: (772) 452--1553 Fax: (772) 452-1578 Commercial Residential
PERMIT APPLICATION FOR: T Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION;
Address: i i 0 CQ-U.n f-'% J e- I
Legal Description: Do (I-,, y 1\yc5 c on cooy.tii rt X �v+ sb V V��+ ��2 �:r ►�....T..�
Property Tax ID #: -o� - oo mo _3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION: INFORMATION:
CONTRACTOR;
Name cs
Address:zz
Name: Y[)Se h Tulty
Additional work toffr orme under
this permit —check
a appy:
E -Mail:
Fillin fee simple Title Holder on next page ( if different
from the Owner listed above)
F1MVAC Gas Tank
❑Gas Piping
Shutters
aWindows/Doors
11 Electric Plumbing
[]Sprinklers
Generator
Roof
Total Sq. Ft of Construction:
of First Floor:
Cost of Construction: $ S5a �
Utilities, -.,n Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR;
Name cs
Address:zz
Name: Y[)Se h Tulty
company: G `k s R 6=nr� Se�� Icts TnC_
Address:. 00a SC Bvlkv;�
City. Ase" & a -c h State:
Zip Code: —?ggIaz Fax:
Phone No. V(" Lf q
City: -? tt- St. uleve- State: rL-
Zip Code: 3 q5Z Fax: U?-- 335-x690
Phone No. 172- 3;?-[-- 3(.19-?-
(.19-Z,Fill
E -Mail:
Fillin fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: t�c?n25is "G`Ul *��i�R 52;ut ceS IY1 CJYHt
State or County License: C• '-t 2 4
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required_
SUPPLEMENTAL CONSTRUCTION LIEN LAW 1NEDRMATiON.
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone=
City: State:
Zip: Phone:
EEE SIMPLE TITLEHOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip. Phone:
City:
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 your Notice of Commencement.
"signature of Owner/
of Contractor
STATE OF FLORIDA. STATE Of FLORIDA.
COUNTY OF �5 �- L c COUNTY OF
Thefor Ding instrument was acknowledged before me
this 2 day of M wr-c,k 20 Eby
(Name
Persona
Commission No.
Revised 07/15/2014
OR Produced Identification
ticed
(Seal)
The forgoing instrument was acknowledged before me
this It day of Ac" -s h 20 -L(I by
(Name
Personally Known } OR Produced Identification
ypeT� tenni+cation Produced
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS