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 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
Address: -1-)"
Legal Description:
11-
I/)
�� 111
' f
I"I�
V \\I
�"I\
, �"'
Address: �• 'J -. LC \2c
Company:- "
Crit
Cit y.l'S-�ii.lY�l2t���-l'E Stater
Zip Code:F�1
Phone No.lm-nl
Property Tax ID
CA
1�
l�y�\��/ _ C Lot No.
Site Plan Name:
FIII in fee simple Title Holder on next page ( if different
from the Owner listed above(
E -Mail:
Block No.
Project Name:
���''�''-�e�
Setbacks Front
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
a xa.-e r YWINCY
y
CONSTRUCTION INFORMATION:
Tank LIGas Piping LJ Shutters
L.J Electric L-�(Plumbing I iSprin
Total Sq. Ft of Construction:
Cost of Construction: $ I
FIWindows/Doors
11 Roof
So. Ft.of First Floor:
Utilities: []Sewer 11 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name �1l_
Name: E-40
Address: �• 'J -. LC \2c
Company:- "
Crit
Cit y.l'S-�ii.lY�l2t���-l'E Stater
Zip Code:F�1
Phone No.lm-nl
Addr
CA
City: i
Zip Code:
Phone No
�]State:
Fax: /Xd 021QL��1
E -Mail:
FIII in fee simple Title Holder on next page ( if different
from the Owner listed above(
E -Mail:
`
State or CountyLicense:
It value or construanon is Ppw or mora, a
SUPPLEMENTAL CONSTRUCTION LIENLAW INFORMATION:
Name: — ---""
mun (GAGE COMPANY: Not Applicable
Address.
Name:
City:
Address.
ZIP: Phone: State: _
City; State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:
BON DING COMPANY;
_Not Applicable
Address:
Name:
City:
Address:
Zip:Phone:
City:
ZIP:Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made
to obtain
1 certify that noa permit to do the work and Installation as Indicated.
work or installation has commenced prior to the issuance of a permit.
which I in c Pic with an representation licme C.no c granting, permit will authorize the permit holder to build the suhinn .rv,,.....�
.r.......__ .. Y..PP' �_,_. _ _
In considenti n of the granting of this requested permit, I do hereby agree that I will, in all yrespects, perform the wsrrk Iy.
In accordance ith the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following ullding permit applications are exempt from undergoing a full concurrency review: room additions,
accessory stru ures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING T OWNER; Your failure to Record a Notice of Commencement may result in your Paying twice for
improvements to your property. A Notice of Commencement st be recorded and posted on the jobsite
before the first inspection. f�you intend to obtain financing, o suit with lender or an attorney before
commencing work or COr I your Notice
STATE OF COUNTYOF ORID�, n„1 Al IQ n
The f,Qjg�ing instru nt as acknowled a before me
this � day Of G� J ZM by
The for of instru t as acknowledged before me
this Zd of20Mby
i oIye (6) ur_v
j Rme of persona n wledeina l
Type of Identification Pro use .ASN erson
ype o'
Commission No. d My COMMISSION BFF,111,
EAFwRI�S May 7, 201 omml
n
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR I PLANS
COUNTER REVIEW REVIEW REVIEW
ATF
mate or Florida I
OR Produced Identification
VEGETATION SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW