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HomeMy WebLinkAboutBuilding Permit ApplicationDate: -- - - - -- • • �•16c I sv t-%Jn 1A1-rL11LA i 1UN f U BE ACCEPTED Permit (Number: Build n Permit nnUrni-irt Plonn/ngond DevelopmeniServices Building and Code Reguiation Division 2300 Virginia Avenue, Fort pierce FL 34952 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 LOCATIGN: Address: f NP Legal Description: Property Tax ID Site Plan ]Name: ~^ Project Name: Setbacks Front Back: Right Side: Left Side: 1DETA(LED DESCRIPTION OF -WORK: L 4C] �( I lz� rW+wr(1_( lrs0- 2Cj. e r CONSTRUCTION INPORMAT-10 A itiona wor to ee ej rrormed un er this permit - C ec a t app Y: HVACt—�I Gas Tank E]Gas Piping Shutters L=1 Electric i V! Plumbing Sprinklers Generator Total Sq. Ft of Construction: S Ft, of First Floor: Cost Of Construction: � �J`T � Utilities. _ Sewer [ _I Septic OWNER/LESSEE: Namee , L City: t Zip cc Prone E -Mai Fill in i from t Ow .l , �LE —Mate: Fax; simple Title Halder on next page (if different Owner listed above) Lot No.-i�. Block No.q` jQ Windows/Daors 11 Roof CONTRACTOR: Name: Lrtr�DV Tvlly Building Height:— Company: Gmeil�IrA6, Address: qua 5C al,- -6,-k A) City: T -6 -rt a t, (_,J c: kp State:l~ _— Zip Code: Mg S2 Fax:7 Z-�,31S-,Q go Phone No. 7-7 - ? - 3G43 Z E-Mail:%eness �vnv�4s Se`tdtc State or County License: k Z If value t construction is $2500 ar more, a RECORDED Notice of Commencement is required. SUP LLEMENTAL CONSTRUCTIO ...N LIED LAW INFORMATION - Not IFORMATloN. Root Applicable Natn4�: MORTGAGE COMPANY: Address- Name: Cit Address: Zi State: : P= Phone: City_ Zip: Phone: FEE SIMPLE TITLE HOLDEf8: Not Applicable Name: �` BONDING �(3�iPAfVY: Address: Name: City: Address: Zip: Phone: City: Zip: . Phone: ------------ Not Applicable —State: ...Not Applicable I certify that no work or installation has commenced prior to the issuance of a permit. w Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which' in leas conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such strrsctu�e. Please consult with your Home Owners Association and review your deed for any restrictions which mayapply. In consideration of the granting of this requested permit, I do hereby agree that l will, in all respects, perform the wk in accp dance with the approved plans, the Florida Building Codes and 5t. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessa structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARING TO OWNER: your failure to Record a Notice Of COMM encement maresultimprovements to Your property. A Notice of Commencement mu be recorded anid posteour d o�n�thtwice for e jobsite before the first inspection. if you intend to obtain financing, consult with lender or an attorney before commenein worm or recordin our Notice of Commencement_ signature of Owner/ STATE OF FLORIDA , COUNTY GF 5"k C c ;` The or ping instrument w s acknowledge before me this day of 20 Vkjaby STATE OF FLORIDA. COUNTY OF ,; The for Ding ins' ument as acknowledged before me this day ofC� 20 by (Name �•���asrvrce.sbm a iai y ,11, Ilt is ; Pl157lb-a:}'_ a-- i s Personally Known t. OR Produced identification <7 Persolly Known OR Pr©Producedicer€tification TYPe '� work Produced na YPe o "tncatfan produced Commission No. (Seaf) Commission No. {Beef} Revised 07/15/2014 REVIEWS �FRONT COUNTER BATE COMPLETE IIIITIALS ZONING ( SUPERVISOR REVIEW f REVIEW PLANS REVIEW VE13ETATIOI-I REVIEW ii f SEA TURTLE tl REVIEW MANGROVE REVIEW