HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number -
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-2578
Commercial Residential IV/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:.
Address: 10�* dt i C
Legal Description: 'A u ,r �Sft �� r�fi �f� 611, 7 Lq
PropertyTaxlD#: YD?. - rm�d� oos,
Lot No.
Site Plan Name: Block No. -7(
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF`VtlORK;
)V41 -p tac , m /,'A -c 4VM- ` .F— r Hca V ,e--- -4-6 `i k4—
CONSTRUCTION INFORMATION;
Additional worK toe e orme un er t is permit — the
HVAC Gas Tank []Gas Piping
L=1Eleciric Plumbing O5prinklers
Total Sq, Ft of Construction:
Cost of Construction: $ _ _ S
OWNER LESSEE.
Name___Uj[0 k_
Address: ly' ri q
City:IoLRorw State:
Zip Cade: �23[y ( Fax:
Phone No.
E -Mail:
all apply:
Shutters Windows/Doors
FGenerator 0 Roof
Sq. Ft. of First Floor:
Utilities:Sewer 11 Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed alcove)
CONTRACTOR:
Name: T6SeD4l 1"v
Company: ► rs�rnbi c.S
Address- -Loa sc sol+dr, AVP—
city: F
ftcLsr, l_dC t state: %L.
Zip Code: 34R5Z Fax: _712 ~ 3X- D,1a90
Phone No. T-7 2 - 3 7.. 3(. 8
E-Mail:�iis��vinbt` Se�td�c rn t?rn
State or County License: LA I
If vaiue of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER. , Not Applicable MORTGAGE COMPANY:
Name: Name: Not Applicable
Address: Address.
City: State: City:
Zip: Phone. Zip: Phone: State:
EEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
BONDING, COMPANY:
Name:
Address:
City:
Zip: Phone:
.Not Applicable
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 worts or recording your Notice of Comrnenr_ernenf
signature of Owner/
of
STATE OF FLORIDA, STATE OF FLORIDA
COUNTY OF 51- c ;' COUNTY OF ;'
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2,Zday of �rG4- 20 11, _by this 11 7 clay of _ cc.��_ 20 z(e by
(Name
ry
Personally Kno�nin _ OR Produced Identification /� Personalty Known_771()R Produced Identificatian
TYP--Gf Ideft4fiGatimProduced ype tion Produced
Commission No. (seal)
Revised 07/I5/2014
REVIEWS IIRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
Commission No. (Seal)
SUPERVISOR PIANS VEGETATION SEA TURTLE
REVIEW REVIEW REVIEW REVIEW
MANGROVE
REVIEW