HomeMy WebLinkAboutBuilding Permit Application I,I
ALL APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //I J,-,
Date: �L �201� Permit Number: (iVJ��'C/i'
RECEIVED
Building Permit Application
Planning and Development Services MAR 2 3 2016
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
i
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the en;d of line
PROPOSED IMPROVEMENT.LOCATION
Address: 701S. 33rd Street, FT. Pierce, FL 34947
Legal Description: (Project)
Property Tax ID#: 2408-701-0012-000-7 Lot No.3/9/10
Site Plan Name: PALM VISTA ' I Block No.
Project Name: PALM VISTA
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF WORK i:.
Replace meter and re energize power
CONSTRUCTION INFORMATION
Additional work toe e orme under this permit-check a appy:
HVAC E]Gas Tank ❑Gas Piping _Shutters '! Windows/Doors
Electric 0 Plumbing Sprinklers FIGenerator I I lRoof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ ��J O��- Utilities: _Sewer F-Septic . i'I Building Height:
OV1/NER%LESS,EE ; CONTRACTOR j YIA „ ' y
Name Robert Bellissimo % oli �' ,1 " Name: � / r
Address:701 S. 33rd Street Company: a' (:
City:. Fort Pierce State: FL Address: 2 Pc�r k- Qr _10
Zip Code:` 34947 Fax: City: ;il State: �—
Phone No. 954-247,0283 �Z� ��I Zip Code: c?J +G r6l Fax: 7
E-Mail:rbellissimo@attinet Phone No. $to I - !14 -0 1 3.
Fill in fee simple Title Holder on next page(if different E-Mail: & C E 1AJ C P plC' L• l_QM
from the Owner listed above) State or County License:'. E C000 s 1 Orj
I I
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required:i
I
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 Counter 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 you property.A Notice of Commencement must be record posted on the jobsite
before the first ins ion. If you intend to obtain financing,consult wit der an attorney before
commencing w o recording our Notice of Commencement.
s
_Sign a of Owner/Lessee/Agent S' ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTYOF
The foring instrument was acknowledged before me The for oing instru n was"acknowledged before me
this day of 2 ftt 20L,§-by this day of 0'" 20 ,0 by
(Name of person acknowledging) (Na f person acknowl ng)
( nature of Notary Public-Ate of Florida) ( nature of Notarylic ate of Florida)
Personally Known OR Produced Identification Personally Known V/OR Produced Identification.
Type of Identification Produced Type of Identification Produced
Commission No 6L $70 90/ s':: (Seal) Rp Commission No.�LrB7D7 ` (Seal)
t * 6aYY(,'OA1u W ON#ff=41 �°`: :° .,. dOANMORO
,�,� � `',BoadedTtwBudpdNohryliavlus ,y vr EXPIRES:Mftj,mj7"
Revised 07/15/2014 'MMOPI CetNo�syS a
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
-COUNTER REVIEW REVIEW REVIEW REVIEW , REVIEW, REVIEW
DATE
COMPLETE
INITIALS `