HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE I iFO 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 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: } z4 L- «tom
Legal Description:
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yy
Property Tax ID #:C]I - �4t - �(�.- - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: _ Left Side:
DETAILED DESCRIPTION OF WORK:
1+Ac-\'/ C i�
VCLCY_C
CONSTRUCTION INFORMATION:
Additionalwork to be erformea un er Ns permit - c ec all appy:
HVAC E]Gas Piping Shutters Q Windows/Doors
s Gas Tank _
Electric Plumbing 11 Sprinklers El Generator Roof
Total Sq. Ft of Construction: Y SFt.I of First Floor:
� � Sewer Septic Building Height:
Cost of Construction: $ ��' Utilities: I —
OWNERAESSEE:
CONTRACTOR:
Name Name:
^�'
Ad s: Company:
t� � State: C - Address: -v .
City. '1 Jc-
Zip Code: Q Fax: City: � C) State:
Phone No. Zip Code: 0 Faxq ac _(
E-Mail: Phone N
Fill in fee simple Title Holder on next page ( if different E -Mail: s i�,J .F Cs
-+�t•
from the Owner listed above) State or County L' ense:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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.
_ Signature of Owner/ L
e Age t ;
STATE OF FLORI A
SUPERVISOR
COUNTY OF
VEGETATION
SEA TURTLE
MANGROVE
The fArgoing instru nt was acknowledgegefo+re me
A,
this � day of
20
REVIEW
REVIEW
(Name of person acknowledging )
(SignaNre of Notary Public- ST�te of Florida )
Personally Knowny OR Produced Identification
Type of Identification Produced
Commission No.vv- 6�3
! `�r'• JOYCE MICHAUD
't MY COMMISSION # FF 0
a'< XPIRES: April 25, 2018
a�y;.•` Bonded Thru Notary Public Underwriters
Revised 07/15/2014
s
Signature of Contractor&cinso older
STATE OF FLO A
COUNTY OF
The fo tying '1sstru -enf was acknowledged before me
this day of 20
�Zp�� W % e�)
(Name of person acknowledgingt )
(�'
(Signat rt of Nbtary Public- State of Florida )
Personally Known L_A OR Produced Identification
Type of Identification Produced
CAmmission Nd' '
JOYCE MICHAUD
LXP(RES: Ap6125, 2018
Bonded Thru Notary pgUic UrWerwnilers
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
COMPLETE
INITIALS
ALL APPLICABLE NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
4 Date:Permit Number:
J
Essig
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 LO ATION:
t;
Address:
Legal De cription:� :�1C� -, 1 f-\C
Property Tax ID #; c��� � L s� c, wc). C;�_ Lot No.
Site Plan Name::. Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILEDDESCRIPTION WORK:
jOF
`� r
as�
CONSTRUCTION INFORMATION:
ationa work to be per Orme under this permit — check a apply:
LHVAC L JI Gas Tank []Gas Piping _ Shutters Windows/Doors
❑ Electric ❑ Plumbing ❑ Sprinklers L1 Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
'n
,L Sewer E] Septic Building Height:
Cost of Construction: $ ���� _ ' Utilities.
OWNER/LESSEE:
CONTRACTOR:
Name i v
Name:
Address: Io `5
Company:
Address: r�
City: �.��-1 State: _C_
Zip Code: Fax:
City: ter _ State:,
Phone No.
Zip Code:- ] Fax':
E-Mail:
Phone N, o. -�—
E-Mail; :^ — L(L44
Fill in fee simple Title Holder on next page ( if different
State or County License: 1 �I
from the Owner listed above)
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 recordiniz vour Notice of Commencement.
_ Signature of Owner/ L
et
t
STATE OF FLORI A
COUNTY OF
The forgoing instru nt was acknowledged efore me
L day by
this of
20
(Name of person acknowledging )
of Notary'Publl'N5tate of Florida )
Personally Known 'f OR Produced Identification
Type of Identification Produced
Commission NA `
Revised 07/15/2014
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
JOYCE
s
Signature of ContractorAie6ns older
STATE OF FLO A
COUNTY OF
The forgoing instrumgrU was acknowledged before me
this Cr day of C 20 y
(Name of person acknowledging )
of Notary Pubri'o,,State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
mission NA t
EXPIHES: April 25, 201a
BoMed bru N%1&y r'ublw UrrdQmMem
ZONING SUPERVISOR I PLANS
REVIEW REVIEW REVIEW
JOvr_ ,
4 Ff
��(Pff1E5: r�iP 25,
Bo�dedThruNola pU� rr
VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW