HomeMy WebLinkAboutBuilding Permit ApplicationDESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State: _
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 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.
lC►� D.
_ Signature of Owner/ Lessee/Agent
STATE OF FLOF�IQy, � ��
COUNTY OF I� (� YTI.
The f ng instr ent was a knowledge efore me
this y of 20 aby
(Name of person acknowledging
0 , ,JA)
(Signature of Notary Public- State of Florida )
Personally — Identification
Type of Ider-'n CRYST'A� A
yrpsona Known OR Produced
VEDO
Commission M_ C ION �j4048
EXPIRES July 31, 2019
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
Signature of Contractor/ License Holder
STATE OF FLOTraj���
COUNTY OF ��VV��
Thef6q�piinng instr en was cknowledgIdbefore me
this `ri y day of ( 20by
(Name of person ging acknowled
�j i l�'0
(Signature of Notary Public- State of Florida )
Personally Know x U Q C� T.
Type of Identific t�j$ri , o _c$s L0 1
uUmIs£ J4048 f
Commission No. EXPIRE., (Seal)zilt9 I
OeMMI99101r W rr*v*u**
EXPIRES July 31, 2019
SUPERVISOR PLANS VEGETATION I SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
a.m.
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 'w,' Residential 1/
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Li I Ke -dor b Kk k j Q. Lhm3e Cu.-(:, 3.5 TUI\ Na-fer Sou rvz i- eAt
7R -k n.p � 4 • i 0 �R i0 KW
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Additional work to bje�ertormed under this permit — checK all apply: �
HVAC LJ Gas Tank ❑Gas Piping
Shutters ❑ Windows/Doors
❑ Electric ❑ Plumbing []Sprinklers
❑ Generator Roof
Total Sq. Ft of Construction:
Sq. of First Floor:
Cost of Construction: $ 2500.00 Utilities: F] Sewer ❑ Septic Building Height:
( CONTRACTOR:
/
Name 4 lobef w_r'iv_ Acl 1p_f Y)D
Name: Kim Wilson
Address: 1 171111_ I'd AAX, A ff `4A
Company: Premier Plumbing & Air LLC
City: o5U1XamL+ State:
Address: 108 NE Dixie Hwy
Zip Code: 23do I Fax:
City: Stuart State: FL
Phone No. 900.502a 161aIq
Zip Code: 34994 Fax: 772-692-1094
E -Mail:
Phone No. 772-692-2500
Fill in fee simple Title Holder on next page ( if different
E -Mail: preplbgac@gmail.com
from the Owner listed above)
State or County License: 25222
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.