HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code .regulation Division
2300 Virginia Avenue, Fort Pierce FL 34382
Phone: (772) 462--1553 Fax: (772) 462-1578
Commercial Residential V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Add
Legal De5crlptlon:
Property Tax ID 4--
Site
:Site Plan Name -
Project Name:
4--T-Kt
Setbacks Front Back: Right Side:
DETAILED DESCRIPTION OF WORK:
Left Side.
Lot No,a��
Block No.
CONSTRUCTION INFORMATION:.
A 1''tjjiona vwor to e e Orme un er t Es permit- e ec aapp y:
L_lhiVAC Gas Tank Gas Piping _ Shutters n Windows Doors
I.�t
Electric V Plumbing Sprinklers l Generator 0 Roof
Total Sq. Ft of Construction:
Cast of Construction: $ —5-s
-'o
S Ft. Of First Floor:
€Jtilities:Sewer ElSeptic Building Height:
Name �1
Add ss;
City: C p t State: L—
Zip Cone: c Fax:
Phone No,
E= -Mail:
Fill in fee simple Title Holder on next Page ( if different
from the Owner listed above)
CONTRACTOR_
Name:._ ()5t',-Dh TD
Company: 2 t �Irn6i C �-
Address: S0tl-�.v Ave -
City: S S<ekp- State: FL -
Zip Code: L9!5z _ ^_ Fax: - . 36-�,6SD
Phone No. -1'7%- 397- 3(,Z Z.
E -Mail: GeneslsPLum� olv-Ge RXI.f6m
State or County License: , `x A 1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGl�Efi/ENGINI=ER• , ,
Name:
Address:
City:
Zip: Phone:
.� Not Ap
State
EEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
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.
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 paols, 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
commencinR work or record in our Notice of Commencement_
!Signature of Owner/ Lessee/Kie
STATE OF FLORIDA,
COUNTY O€ SV_
The r ping instr m n was'a^ck�n,ow edge before me
this &I day of � 20 Mby
Personally Known
Commission No.
Revised 07/15/2014
re
STATE OF FLORIDA _
COUNTY OF f
The f oing ins k [edged before me
this day ofume t as ac20 Ism` j,�� by
(!Name of WerA a
.OR Produced Identification /' Personaily Known) OR Produced Identification
deed yp' ee hientification Produced
(Seal)
REVIEWS FRONTZONING
COUNTER I REVIEW
DATE
COMPLETE
INITIALS
s
Commission No. (Seal)
SUPERVISOR PLANS 'VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW