HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ff
Date: Permit Number: 1 ' 00 0
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 �1
PERMIT APPLICATION FOR: El
Renovation �,��-�,�-\pr �etrpGlfA
PROPOSED IMPROVEMENT'LOCATIO�N,
Address: 2_0t 0__)onV\-a_ CA , Por " S+ Lue-
Legal Description: ex- Qn i+ s F)0
Property Tax ID#: ;&(3- !560 000 - A Lot No. �
Site Plan Name: 7-d i-4 e_ C Block No. rJ(�
Project Name: 20 \ G on
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF V1/ORK: �!
M►hiw►�,m . QrjWaJ( �MAAnVOQXYn t o6r%K9 remo t ) pmik+
Gh0.h9 �� C4- E`e.CA-e t e arl PcLh eA -Freti n 1'ZS 0.m P �-o ;.400 a.rr? 1 rL�et-t0
G 4,o.e".g e. o L-%t o.Ip (✓� e'G.A-V-'L CCLA SW c-krc r,e 5 enol a LA;:k k e.t
CONSTRUCTION INFORMATION.
Additional work toa er orme under this permit-check a appy:
HVAC Ei Gas Tank []Gas Piping _Shutters ❑Windows/Doors
IT,7111"
_Electric ❑ Plumbing Sprinklers 11 Generator F] Roof
Total S Ft of Construction: r
Sq. �aZo� � S . Ft. of First Floor:
Cost of Construction:$ � 600. 00 Utilities: _Sewer Septic Building Height: S+6 r Lill
OWNER/LESSEE:, . n. a CONTRACTOR;,
Name Vineen+ Onoc Name:
Address: Company: 1 0:+'t O rl
City: a Ptexce, State: 1=L. Address: ft) iZZ�I
Zip Code: _-�q 9-1°1 Fax: City: 1p:T P c ex—C,' State:IPL-.,
Phone No. _112 e 7(A •-27T_2-1 Zip Code: S, ' Fax: `1-7 Z M5 -ZZ5�i
E-Mail:hQ.nde e, ':_;MQ9 (2j uQhd® .COYY\ Phone No. `11-2— 2�1 Z - 0000
Fill in fee simple Title Holder on next page (if different E-Mail: has 6e_ sz),irA ® LAak1m.(SM
from the Owner listed above) State or County License: Jf-ZCXa i2a
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION.-
DESIGNER/ENGINEER:
NFORMATION: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
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 yo paying twice for
improvements to your property. A Notice of Commencement must be recorde�an ost - -the jobsite
before the first inspection. If you intend to obtain financing, consult with lendeney before
commencing work or recording our Notice of Commencement.
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s
_Signature of Owner/Lessee/Agent Signature of ntract /License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF Sl—
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 by this k'10day of 20 Xtj by
I
(Name of person acknowledging) (Name of person acknowledging)
C90,Aa-
(Signature of Notary Public-State of Florida) (Signature of Notaryi Public-StatIf Florida)
Personally Known OR Produced Identification Personally Known ! OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No.�CC-12-o 37Z y
SARA OLEARY
MY COMMISSION H FFI26322
P
EXVIR'OFPO� ;Numnba
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS