HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABL 1NFO MU5 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 34.982
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: a-7 V i) a '' i �r"'V I'gz_
Legal Description: ,Oani S� C�.�{�r CAI�vU�>� C" l tQ�-e l.�D�DCVl.b1a
Property Tax ID#: 1 -30/ — _900 1; 9,5 - 00 0- Lot No. 7
Site Plan Name: D Z Block No.
Project Name: t/u l 1'•T Z
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
L L- PFT 1 0 f13 op j'7v.rY 1 cc10 t 51st
51, C $) A-Lc-Z -0
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit-check a appy:
HVAC Gas Tank ❑Gas Piping Shutters a Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 3, 1 �. Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name �0 lA'i r/� Z- Name: it aM &,7Rb!,eJ
Address: a:� Company: ID.VT, t4u>^ri C-A",e am'
City: CQ_ State: Address: 3 1 o O N yp, fzA� Uu�
Zip Code: 39 Ct•S Fax: City: 1pr,- Z-RrCj� State:
Phone No. 7 7Z - t-)Y? S Zip Code: 3-�Ci5) Fax: 194-I S 0
E-Mail: -sbnoVlb, 11,-D7 ✓bQ Phone No. 11 •7 Z2- r794 - IS 9)
Fill in fee simple Title Holder on next page(if different E-Mail:AVd"yl U rri
co
from the Owner listed above) State or County License: a93 '7 Y
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION 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 thepermit 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.
Signature olOwner/Lessee/Contractor as Agent for Owner Signaturb of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 _by this day of 20 by
1
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS