HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: j —t ` �� Permit Number:
a
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial `P Residential
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION:
Address: sad '5 • IXCf-" ir--_..-------
Legal Description: -, ,
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Property Tax ID #: -3535 • W-3 • DO-7I - 406 I Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: — --i
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U k-C l-E Imo- L (,h&tomer ttif'c*C,
CONSTRUCTION INFORMATION:
AHi�a1—work-to eerforme under Trispermit =c 6_E a1T app y— ---
ZHVAC Gas Tank E]GasPiping Windows/Doors
In
11 Electric Plumbing Sprinklers In Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 2500.00 Utilities:n Sewer []Septic Building Height:
OWI�E.f?�LESSEE:
CONTRACTOR:
Name: Kim Wilson
Name 0 i.(—A �1 V
Address: I �ii(�j�Q(�_ �
Company: Premier Plumbing & Air LLC
-
City: I State: NJ
Address: 108 NE Dixie Hwy
City: Stuart State: FL
Zip Code: 0-77 (a Fax:
Phone No.
Zip Code: 34994 Fax: 772-692-1094
E-Mail:
Phone No. 772-692-2500
Fill in fee simple Title Holder on next page ( if different
E-Mail: preplbgac@gmail.com
State or County License: 25222
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Not Applicable MORTGAGE COMPANY: ! /Not Applicable
Name: Name:
Address: Address:
City: State: City: State
Zip: Phone: I Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _IZNotApplicable
Name:
Address:
City:
Zip: Phone:
Name: _
Address:
city:—
Zip:
ity:_Z p: —
Phone:
I certify that no work orinsCalWon 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
cornmencine work or recording your Notice of Commencement.
- S
mor/License Holder
�+ essee/Agent e
STATE OF FlO�I�q� STATE OF FLOI�Fp
COUNTY OF jj�` (( COUNTY Of lrl C V ►✓
The foigoing in knt a knowledg tru fore me The f g insnt was acknowledg d before me
this , day of 20 this day of lu 20 by
(Name of person acknowledging) (Name of p rson acknowledging)
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification Personally Known �Reele
Type of Identification Produced Type of Identificati -11ty 014YSTAL A 4UEVC
DO
MY COMMISSION # FF904048
Com =commission No. EXPIR"1931,2019
VE1OV)398-0'53 FbridallotaVS9wIce,cw
MYCOMMISSON #F
EXPIRES July 31, 2019
Re ' /45/20 k4raalloa servlca.cerr
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS