HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFER MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR: To Select from dro-pbox, click arrow at the end of line
PROPOSED IMPROVEMENT t.00ATiON:
Address: dq 9 q mwkeel RA
Legal Description:3S--.7,7
Property Tax ID #:_Z 322 OCb 3— C c _
Lot Na.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
!A � C
CONSTRUCTION` INFORMATION:
A Mona wor to e ertorme un er t is permit— c ec a appy;
HVAC Gas TankGas Piping _Shutters Windows Doors
�j Windows/
Doors
Plumbing [ISprinklers Il Generator 1:1Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 5—Yo.
8191 --
Off# NER/LESSEE:
Warne avi c-( /wed"
Sq. Ft. of First Floor:_
Utilities: I ,1 Sewer E Septic
Address;—
City:6f (' State: �G
Zip Code: 3Lf 1, `1 .5— _ Fax:
Phone No.
E -Mail:
Fill in fee simple Title Folder on next page (if different
from the Owner listed above)
CONTRACTOR
Building Height:
Name:�--
Company:6 t UrP'&
Address: MD SC W_d'n AV0_
City_ art S tJ ekf_ State: L
Zip Code: N 5 2 Fax.?
Phone No,�7 -$
E -Mail: GenQsts uMM> Nt r�rn
State or County License: Ct , 4A-ZvA-Z9 I d
If value of construction is $2500 or more, a RECORDED Notice Of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN.LAW INFORMATION
DESIGNER/ENGINEER: Not Applicabic
Name:
Address:
City:
State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: _y Phone:
z Not Applicable
State:
Not Applicable
I certify that no work or installation has commenced prior to the issuance of a permit.
St.
is in ontflictawith any applicable Mame Dpi finers Association irulesa yaws or and co enanls that malty restrict or prohibit such
structure. Please consult with your dome owners Associations 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
improvements to your property. A Notice of Commencement must be recorded and posteWARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
d on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
camrnencin work or recordin our Notice of Commencempr}t-
%'Signature of Owner/
STATE OF FLORIDA,
COUNTY OF 5V-
'rhe forgoing instrument was acknowledged before me
this --k day of W_ 54�T 20 f6 by
(Name
OR Produced Identification
Iced
Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
QATE
COMPLETE
INITIALS
of
STATE OF FLORIDA
COUNTY OF S�
The forgoing instrument was acknowledged before tree
this. day of 20 by
(Name
known', OR Produced Identification
t►tification Produced
Commission No. (Seal)
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW