HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J
Date: _7 / tO Permit Number:_)k k 07. Q L"
R:at=^err�_ RECEIVE -
D ECE ,
Building Permit Application AUG 1 9 20
Planning and.Development Services 16
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
PROPOSEDJMPROVE MENT LOCATION:
Address: 1 / SOU ... Tw�',� r+'e/C p r �'L,-z
Legal Description:
Property Tax ID#: 9-3 3 3 0/-6)06C a-0 O G Lot No.
Site Plan Name: Block No.'
ProjectName• -
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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u ti d e-r g r&c.* FPL
CONSTRUCTION,INFORMATION "
AdditionalworKtobariarrormed under this permit-c ec a appy:
VAC' ; GasTank �GasPiping. _Shutters ❑.windows/Doors
I
Electric`;'. OP, '`Sprinklers Generator Roof. Roof pitch
Total Sq.Ft;of Construction; - S Ft:of First Floor:
Cost of Construction:$ �yy• co Utilities: Sewer Septic Building Height:'
OWNERAESSEE: CONTRACTOR:
Name k e 3%rr Orr 'G•J Name: V-C.J ee-l -,6.. A c
Address: ll kOv TL.-,^ Cilc fir. Company: n /
State:�� Address: lJ/ w�• C d X�,. #g .
Zip Code:_j,�l `�� Fax: City:_,F1 Pr-t^, a State: r1
Phone No. ( R-- Q °7�?�_ Zip Code: Cc S ce-f' Fax: V1 3
E-Mail: Phone No. �r�Y SGC
Fill in fee-simple Title Holder on next page(if different- E-Mail: �'f"u 6 o ;_7-elec m 4-6 l •mow
'from the Owner listed above) State or County License: 9 ��Z
If.value of construction is$2500 or more,a RECORDED.Notice.of Commencement is required.
I
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 thepermit 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 inspection. If you intend to obtain financing,consult h lender or an ttorney before
commengmg work or recordin our Notic encement.
Signature of Owner/Lessee/Contractor as Agent for winner Signature of Contractor/License Holder
STATE OF FLORIDA _ $vo STATE OF FLORIDA il< x�
COUNTY OF z F� COUNTY OF D0 co
--
is
oing instrum was acknowledge efore 5P Fn
d The far oing instru t was acknowledged before m w s2-
this day of 20�by . R'T-a this day of 20/�by g sg
C- T 2 S T
N�37 C�NTS
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(Name of peLspfi acknowledging) (Name of person cknowledging)
(Signature of Nry Public-State of Florida (Signature of Notary P ic-State of Florida)
Personally Known / OR Produced Identification Personally Known/ OR Produced Identification
Type of.Identification Produced Type of Identification Produced
Commission No. (Seal) Commission.No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS