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 PL 34982
Phone: (772) 462-7.553 Fax: (772) 462-1578
Commercial Residential IV/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 9_6 i E ,4w100."
_._..�7 Rbr � IL
Legal Description: Pi�n2rP((,,L�a/
V'n
e+ �J� .C�'r I
Property Tax ID #: "11 - �J f� ��i - 6 DO - J5 Lot No.
Site Plan Mame: Block No. 2_
Project Name:
Setbacks Front Back: flight Side: Left Side:
DETAILED DESCRIPTION OF'WORK:
CONSTRUCTION INFORMATION -
Additional work to be ertormed under this permit - check all apply:
1JHVAC Gas Tank E]Gas Piping �_ Shutters
1-1 Electric Plumbing Sprinklers I Generator
nn Windows/Doors
Lam! Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ SS(O "0'Utilities: nSewer 11 Septic Building Height:
OWNER/LESSEE. CONTRACTOR:
Name D¢60ruh %7 t'C�.e Name: -37 -h-C"UIly
Address: ,Ot X10,5 _ Cornpany: G,-ne,5 is'P1unL i 5 �ftvict's -rnr_
City: INrfi- L-Lic. I <— State: Address: 1`40), 5C Sal4,6k Pfo-
Zip Code: 3L052 Fax: - City: ?per 1; '. L_iJ&if- State: rL_
Phone No -7-72 - 75 0 Zip Code: 3,4952 Fax: 772- 33S-�'�$0
E -Mail: Phone No. 7'
Fill in fee �Imple Title Holder on neat Page ( if different E -Mail: C�eneSts ii i)r+�brcta+s2rVttl�S(e�_$(il
from the Owner listed above) State or County License: C F=C tw24l 160 �
If value of Construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL 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, 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.
�lgnatreer/ Lessee
STATE OF FLORIDA.
COUNTY OF
The forgoing instrument was acknowledged before me
this day of .>Qvri 20 4Lby
Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
mature of Contractor License H
STATE OF FLORIDA
COUNTY OF S --I-
_ f J-
The forgoing instrument was acknowledged before me
this —L,,7 day of Ajer,' ( , 20 _L�,' by
(Nam ersn� ac 1 /
F Sitvfosao� Ft
Personally Known OR Produced identification
ypT"e�ftdzntification Produced
Commission No. (Seal)
SUPERVISOR PLANS VEGETATION SEA TURTLE
REVIEW REVIEW REVIEW REVIEW
MANGROVE
REVIEW