HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Col
1 1-0 u, 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
Address:
Legal Description: '6-40' 1'5t. -
6�9 UV\+
Property Tax ID #: - C) " OLA C'�U Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
laitigpeal work to be errormed under this permit — cl
9 HVAC ff Gas Tank E]Gas Piping
11 Electric E Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ C E
Name�Y
Address:,` Lo- -j—NJ o Tfi'
"
City: -Pur r�, l—L-6 State -
Zip Code: 'fi �- Fax:
Phone No.
mat appy:
Ey:
Shutters Windows/Doors
Generator Roof
S Ft. of First Floor:
Utilities:cn Sewer D Septic
E -Mail: "J
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
Name: ,� 5I-N-kCkelf
Company::r\ e'if 2a`i ° Aeo hq, LY�C
Address: ��G� `�
City: State: C1
Zip Code: Fax: - &L _x_ggt1
Phone No. - 2 - '522 •33 -27
E -Mail: Lo Ccv' I 4a0ao i C& -y1
41 State or County.License: Ci Cir 7 J
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I�, V_ .�Z ` 1 FIS 6
e -v-
AJT
1n1m,5A-6 t
laitigpeal work to be errormed under this permit — cl
9 HVAC ff Gas Tank E]Gas Piping
11 Electric E Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ C E
Name�Y
Address:,` Lo- -j—NJ o Tfi'
"
City: -Pur r�, l—L-6 State -
Zip Code: 'fi �- Fax:
Phone No.
mat appy:
Ey:
Shutters Windows/Doors
Generator Roof
S Ft. of First Floor:
Utilities:cn Sewer D Septic
E -Mail: "J
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
Name: ,� 5I-N-kCkelf
Company::r\ e'if 2a`i ° Aeo hq, LY�C
Address: ��G� `�
City: State: C1
Zip Code: Fax: - &L _x_ggt1
Phone No. - 2 - '522 •33 -27
E -Mail: Lo Ccv' I 4a0ao i C& -y1
41 State or County.License: Ci Cir 7 J
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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.
r/ Lessee/Agent,
ntractor/License Holder
STAATOF FLSTATE OF FLORI jj
COUNTY OFF COUNTY OF
The far Ging instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 206y this day of 20 P by
(Name of person acknowledging) (Name of person acknowledging )
(Sign ur a o r Pu c -S t� of FI �—
✓ 5,.� �s\s., c
Personally Known OR Prod Liedld -i t ch%
Type of Identification Produced ;
=.fir o •.�
Commission Nott* ) C1'15 ;33 . 2 t(SeaI F 195337
Revised 07/15/2014
(Sign y Pu i of Florida )
���i� �. �#�� ,4�+,,lal�lIII foil
Personally Known V OR Produced IC{+L��j''
Type of Identification Produced p r o
,u v P S
Commission 1\146 19 537 s�{sea) N
+•� S'k
#FF 195337 � .c
1C�STA��.
REVIEWS
All
DESIGNER/ ENGINEER:
Applicable
_Not
VEGETATION
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
REVIEW
Address:
City:
State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
of Applicable
BONDING COMPANY: of Applicable
Name:
COMPLLTE
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.
r/ Lessee/Agent,
ntractor/License Holder
STAATOF FLSTATE OF FLORI jj
COUNTY OFF COUNTY OF
The far Ging instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 206y this day of 20 P by
(Name of person acknowledging) (Name of person acknowledging )
(Sign ur a o r Pu c -S t� of FI �—
✓ 5,.� �s\s., c
Personally Known OR Prod Liedld -i t ch%
Type of Identification Produced ;
=.fir o •.�
Commission Nott* ) C1'15 ;33 . 2 t(SeaI F 195337
Revised 07/15/2014
(Sign y Pu i of Florida )
���i� �. �#�� ,4�+,,lal�lIII foil
Personally Known V OR Produced IC{+L��j''
Type of Identification Produced p r o
,u v P S
Commission 1\146 19 537 s�{sea) N
+•� S'k
#FF 195337 � .c
1C�STA��.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLLTE
INITIALS