HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -1 i4 !-�� Permit Number:
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 x Residential
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION:
Address: 7:3O -S- �tt n Jc U-ni+ I&`2,
Legal Description: U.s`El.)R" bil,f t_-, DULV'1aAe_ 0plMomImiArA -q: Unil ' �(7�
Property Tax ID #f: ]ZtD5 (oZ 0950 000 7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
FDIETAILED DESCRIPTION OF WORK:
Like- 7fpor U- ke NJ C b -an e bu�,- 3-TvN Wa e t- �xu.rct,
P 13 L E -K go kv�!
CONSTRUCTION INFORMATION: _
Additional work to be ertormed under this permit -check all JWU apply:
HVAC Gas Tank[]Gas Piping _ Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 2500.00 Utilities:cn Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: 1
Name0J-05e ( I6tt- —1-Name-:-Kim-Wilson
Address: tai -he_ f- R, ( (s Lx-)
Company: Premier Plumbing & Air LLC
City: Giel'1 i _�) State: e0
Address: 108 NE Dixie Hwy
City: Stuart State: FL
Zip Code: C) -5q- - Fax:
Phone No. =1 a .0-210 - 045D
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
State or County License: 25222
I
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
AE�AA
FRONT
-
DESIGNER/ENGINEER:
Name:
Not A Applicable
PP
x
MORTGAGE COMPANY: _
Name:
Not Applicable
le
Address:
MANGROVE
Address:
COUNTER
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: X
Name:
Not Applicable
BONDING COMPANY: X
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone:
City:
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.
Z4�� S
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA � ��
COUNTY OF IVB
The forgoing instr�4ment was acknowledge before me
this day of M la.2 i! 20 tG by
1�d
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally., CR1Cr&rAid*QU&#g ti n
Type of Id ; i ig1RGgdQf0lAbAISS10N�tFF90494
EXPIRES Jule 91 2019
Commissi �i)
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF
The for in, instru en was a lknowledged before me
this C day of f' 20 by
(Name of person acknowledging)
C,GVU&k
(Signature of Notary Public- State of Florida )
Personally Known
Type of Identifica ed.,
L,IMMIbbION7 F90404a
Commission No. EXPIRES (swy, 2019
FbMeN0t878ervke.cow
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS