HomeMy WebLinkAboutBuildinhg 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 Ft 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: r1 j
Address: ', �0� U 'C -,f(1( ,�i�, t `l �C- _ S149-19 -�
Legal De cription: 12 39 k� 7S� t� I -J) `t` -t , c 1- KYF �, 14 6
Property Tax #: / `- 4 d - �1 Lot No.
p Y ID � ��
Site Plan Name:
Project name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION. INFORMATION:
Additional work to be
rtormed under this permit -check allapply:
E1` HVAC LJ G s Tank In
E]Gas Piping _ Shutters
l=I Electric LJ Plumbing Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ JSS6
Sq.Ftof First Floor:
Utilities: L�J Sewer El Septic
OWN ERAESSE E:
Name.
Address: F�]
City: F�le '(:2 State: FL_
Zip Code:M:2_1Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Block No.
QWindows/Doors
aRoof
Building Height:
CONTRACTOR:
Name:�p 1"Ph
Company: '(7e6pm'i51 lum6'n5
"�!2ftliGt'S -T-nC_
Address: 1g0a 5C 'Bol -Von Ave.
City: Pbrt S $, LU Ck State: FL_
Zip Code: 3gg152_ Fax: 7?2- 335-a,6Z0
PhoneNo. c,
E -Mail; �er 5ts��Vi�brc,a r � S(� �T+tO .P.orr
State or County License: C*c ILA 2.q 1 bad.2
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
1
SUP�LEMENTALCONI STRUCTIQN11JEMLAW INF-ORMA71 i0N:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address. Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
EPEE SIMPLE TITLE F3tOLF3ER: Not Applicable BONDING COMPANY: ^Not Applicable
Name: Name:
Address: Address:
city: ; City:
Zip: Phone: Zip: Phone: I
1 certi� that no work or installation has commenced prior to the issuance of a permit.
St. Luc!' County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which i in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
I structure. Please consult with your Home Owners Association and review your deed for any restrictions whEch 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: `four 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.
;mature of Owner/ Lessee/ c iE e&rnnature of Contractor/ticense H u r J
�S^T/�ATE OF FLORIDA. STATEOF FLORIDA
`L.:. UNtl I OF 571. 6'v �-.'-C COUNTY OF S-/ F- % 1� i•'\
The forgoing inst u ent was ac knowfedge before me The 7 r?Ding in tr ment was cknowiedged before me
this , A day of �20 �by thi�� day c_ 20 by
(iVame o#f:7 son ck � gii) {Name af'k%rso ac . a4 e Eng i• -
IT,
I
t '
fini 4 fTTI��1�i6C f , MF R f11� R"a
r ca isit+4� '2s _R i!
Sig 9 Nota P aleC� e of arida J -�� ,P wary I 1`1.}
Ft-d'S3 lbna�io+a;Saryic+3_cam ria "sr> 4 -
Personally Know ' OR Produced identification Personalty Known i OR Produced identification
Type errs Produced Iype of itientiri-cation Produced
l Commission No. (Seal) Commission No. (Seal)
,
i g
z
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE a
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW 3
DATE
COMPLETE
INITIALS
E