HomeMy WebLinkAboutBuilding Permit ApplicationALLAPPUCABLE INFO MUST COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Planning ond Development Services
Building ond Cade Regulotion Division
B00Virginia Avenue, Fart Pierce FL 34982
phon"' \nzl q1z-15Sz Fax:{.772]. 462-7s78
Building Permit APPlication
Commercial Residential
Address:
Legal DescriPtion:
Lot No
Property Tax lD #:
Block No.
Site Plan Name:
PERM IT APPLICATION FOR:To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVE@
CONSTRUCTION IN FORMAT]ON :
CONTRACTOR:OWNER/LESSEE:
ao*OrnU.
Address:
a,.y, Po'
;v?2187e-3sr6349E3ZID LOOC:
Phone*o.@ffi
E;;;.7
State or County r,.un
Name Kerry uolllns
Address:
^-- FtLrty:
Zip code: 34951- - -r.r'Phonero.@5
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above|
DETAILED DESCRIPTION OF WORK:
Project Name:
Setbacks Front----Back: ,-- Right Side: Left Side:
150 ampere
insure, and replace with Cutler Hammer
requirements
tra
cuit panel that insurance company not
BR series 150 ampere MLO panel to meet insurance
n
HVAC
Electric
Gas Tank
Plumbingtr
Shutters
Generator
f.-l *,noows/Doors
l-l noot
Building Height:
Total Sq. Ft of Construction: + Sq. Et. of First-[lqor:
-CostofConstructio^.it@Utilities:l_l,"*",[**
lf value of construction is 52500 or mgre, a RECORDED Notice of Commencement is required.
x Not Applicable
EONDING COMPANYi I , ruot Applicable
STATE OF FLORIDA
COUNTY OF .61 " ur.+S, *
-
The forgoing instrument was acknowledged before me
thisJ4 dayof $Quf .20 ljr by
3ri;^.1. to . S..Jcl.,e[<
{Narne of person acknowledging }
(signature of Notary Public- State of F
Personally Known .-OR Preduced lde$tiflcation ./
Type of ldentification Produced@
_ Signature of Owner/ LesseelAgent
The forgoing instrument was acknowledged before me
{Name of person acknowledging }
{Signature of Notary Public- State of Florida )
Personally Known *- OR Produced ldentification
Type of ldentification Praduced
ioitnrrrion , ff 96623{
My Comm. ErPhcs APr t7' 2020
SUPERVISOR
REVIEW
I Certiry that no work or installation has commenced prior to the isSuance of a pefmit'
i,h,:'iis,fi'^.trr'tttitfii,?Lfffifi','s#s#Hh*Fh1tHf,",?frtr,tr'ildi.1#Jjit'i5t'fff":..r#]il,ii"*il,fiflii$f*]iffis,j{'?'*1r1n
structure. Please consul
ln consideration of the granting of thls requested permit, I do hereby agree thatl wilL in-all respects, perform the work
in aicorOance with the ippiouEO pians, tn'e rtorioi Building Codes and St' Lucie County Arnendments'
The following building permit applications are exempt from undergoing a full concurrencY review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNIN€ TO OWNER: your failure to Record a lrlotice of comr$encement may result in your FfYinE twica for
imorovements to v;;;'p;;;;rtv. e rrrotiie oi commencement must be recoided and posted on the jobsite'd;i;re th;-i""lnip"rtion.'tf y<iu intend to obtain financing, consuh with lender or an attorney before
commencing work'or recording your Notice of Commencemenl.
Revised 07ll5l2aL4