HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE IN/FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _� r
Date: {� Permit Number: 6C -0 u
V-405
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 _/ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 2.9 19 z_ 12%/5 fC/ly4 18Z_V0 . �% A/9/2G�_ �G-
Legal Description:
Property Tax ID#: ���� �70� gyp? ®Ob/;o Lot No.
Site Plan Name: / - / Block No.
Project Name: A/AI .�-6_4zlA
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF1WORK:
CONSTRUCTION INFORMATION:
Additional work to (e ne orme under this permit-check a appy:
HVAC L_!Gas Tank. E]Gas Piping _Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers E Generator 11 Roof
Total Sq. Ft of Construction: Sq- Ft.of First Floor:
Cost of Construction:$ /r7Zr00 Utilities: _Sewer 0Septic Building Height:
01NNER/,LESSEE; : CONTRACTOR:
Name i �CfQ� � 5;V-61 1'lG Name: j " c V 72
Address::� 0/2:;,//7j4__ Company: 46:2.
City: Stater Address: l Z!
Zip Code: Fax: City: e-e Stater
Phone No. Zip Code:_36g03 Fax: 5-7ej py /-
E-Mail: Phone No. 'C4
Fill in fee simple Title Holder on next page(if different E-Mail: I/s"".) io
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
RAY-06-2016 FRI 10:51 IM Fix: P.001
MDESIGENER/EENG31IN Not Applicable IVIORTCiAGE COMPANr. Ncrk Applicable
Name, Name.
Address: Address;
City: State: city. State
Zip: phone- Zip:— Phone:
FEE SR'P_L_ETrrLE HOLDER: Not Applicable DONDING COMPAW., __._Not Applicable
Name. Name-
Address- Address;
City: City:
Zip, Phone- Zip:_Phone:
I certify that no work or installation has commenced prior ro the issuance of a permit
St,Lucie Coun makes no representation that is granting a permit will authorize the permit holder to bufld the subject structure
which is in convict with any applicable Rome Owners Asiddation rules,bylaws or and covenants that may.restrict or prohibit such
structure.Please consult vwth your Home Owners Association and review your deed for any restrictions vohidi may apply.
In consideration of the granting of this requested permit,I do hereby agree that I Will,in 211 respects,perform the work
in accordance vidth The approved plans,the Florida Building Codes and St Luete 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 tuke 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 tender or an attorney before
tornmencing.work or recording your Notice of Commencement.
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Signature offritractor/IdAOns
e Haider o
STATE OFFLO!!?y
STATE OF FLOR
COUNTY OF COUNTY 01�.
The Bing instru was adknowied*.)3e1ore me Thef oin instrument was acknowledged before me
_day — 264Lt'y A;kl_
this Fday of 201_4S by
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a of Notary Public-State of Florida) 451 re of Notary PubIt41&"- _�jfFlarltda
/ Monally Xr?n —OR Produced Identffi t4ikn_
nally Known OR Produced Identification 'fi
of identification Produced 7ypeafId2ntii2iA0!�!_i U
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NO. commission No. VM al Amin
VA"A.RMADMANCOV101 v FF94M
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JAA E1101 270201
Revised 07/15/2 4 My EWM
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M"EWS FRONT ZONING SUPERVISOR PLANS VEGETA'r[ON SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW AMEW RMEW
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