HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA LE INFO)MUST
%UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^, ✓�=��
Date: 1 I 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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT,LOCATION
Address: 429 S '1414"fe r /�,P
Legal Description: Q11 e(n �TOIV f)(0 CbY t1A t, 464 . !
Li yy 00b C0- # aU 175 yr 3$5 -2S(,
Property Tax ID#: )-Y)q G DZ b d qa DO D -6) Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED:DESCRIPTION F.,WORK .
7t _<-ej Ilt IC e /I'A huA w4-Qr
CONSTRUCTION.IN FORNfATION
Additional workto e e orme under tis permit-check
c ec. a appy:
HVAC L..J Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors El
11 Electric D Plumbing Sprinklers [Generator El Roof
Total Sq.Ft of Construction: 5 Ft.of First Floor:
Cost of Construction:$ /Z00�"� Utilities:,n Sewer F—]Septic Building Height:
OVVNf R/LESSEE: CONTRACTOR: .
Name SZ11 S Mme.-fel` 4%-e 46C Name: til %►
Addresss: lit k) Prmljif Wely Company:t�e (1V,► 6R(4- Qt)4 - W_
City: V-1, State: (_L. Address: ooZ-
Zip Code: Jy'06(e Fax: City: P,51, State:P,
Phone No. 2;2_ -00 ;7 Yid S - Zip Code: -LRS Fax:
E-Mail: Phone No.-TV '-)_�)(, ' 797
Fill in fee simple Title Holder on next page(if different E-Mail:kkf e0ti
from the Owner listed above) State or County License: �"fl /t/2��//9
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTION•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 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 our Notice of Commencement.
s:E:'
_Signature of Owner/Lessee/Agent s;;. ature of Contra cense Hortder
,•:
1
STATE OF FLORIDA - '' TE OF FLORIDA
pi ♦ ,`
COUNTY OF "" C LINTY OF .
$" forgoing instrument was acknowledged before me
The fo oing instru t was acknowledge before me 2
tV P1 I day of 20/�by v J day of sSe'7k-nj 20 L�9 by
C7A V
os
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(Name of person acknowledging) ame of person acknowledging
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(Signature of y
tary Public-State of Florida) V ( ' nature of Notary Public-State of Florida) /
Personally Known OR Pro I i d Identification Pers nally Known OR Produced Identification V
Type of Identification Produced a of Identification Pr d ce
Commission No. (Seal) Commission No. I=.,••�
NOAI of now
No C�7 fool
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS