HomeMy WebLinkAboutBuilding Permit ApplicationACL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO 13E ACCEPTED
Date:
Permit Number:
Building Permit Ann icntinn
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 'V/
PERMIT APPLICATION FOR: To Select from dro,Pbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID #: `%^ Z ((— �o 6 _ Lot No. C g
Site Plan Dame:
Project Name:
Bieck No,
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
e p i ckC-e_ i c. w cc- ex
CONSTRUCTION INFORMATION
A ��Jt''jj�ona wor to jee crime un er InGas
permit— cE1HVAC 1 I Gas Tank Piping
L1Electricpfurnbing OSprinklers
Total Sq. Ft of Construction:
Cost of Construction: $S�TQ&__
Tom, apply:
u_ Shutters
FIGenerator
Sq. Ft. of First Floor: _
Utilities; 0 Sewer O Septic
OWNER/LESSEE: CONI
Name '6 S
Address: a3 La__t"iwre. ry,compz
Name:
City:y (! ` ^ State: Al
-
Addres
Zip Code: kr7o Fax:
City: J
Phone No.
Zip Coc
E -Mail:
Phone
Fill in fee simple Title Holder on next page (if different
E -Mail;
from: the Owner listed above)
State o
aWindows/Doors
Roof
Building Height;
KACTOR:
ny: e 'Jm
s; 1L Ave-
� rt s t ci c t. State: FL
e: � SZ Fax: _U7-; siS oMa
Genesisrplurrnloa Gel V_ cmc {fityt
County license: l W 2 b
i
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
Address: Name:
City: Address:
Zi State: city:
P= Phone: state:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY:
Name: `— —Not Applicable
Address: Name:
City: Address:
Zip: — Phone: City.
Zip: Phone:
I certify that no
oy work or installation has commenced prior to the issuance of a permit.
St.Lucl
es no
on
t is
wh€ch isinoconflict with any applicableiHomeaOwners Associationirules,ill by bylaws or and covenantize the permit s that maydrthe estrict oJrprohibitsuch
structure_ Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
fn 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
corrimencin worl€ or recordin our Notice of Commencement.
!signature of Owner/
STATE OF FLORIDA. STATE OF FLORIDA
COUNTY OF - c :` COUNTY OF S','-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this _22day of ,� 20 Lr -by this ;Z-2-dayof fr 20b l
,.lam y
{Name „son ckfr€o} 12�1gi , (Name gf'i�erwn acltxkn rl Ino i7 �--
Personally Known OR Produced Identification
Commission No. (Seal)
Revised 07115/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS —
SUPERVISOR
REVIEW F
Personally Known } OR Produced identification
yp�tt€rcatlon Produced
Commission No. (Seal)
PLANS
tEVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW