HomeMy WebLinkAboutBuilding Permit Application I i
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j 'n
Date: Permit Number: I (
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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 X
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED,IMPROVEMENT,LOCATION:
Address: 3161 Dame Rd. Ft Pierce, FI 34951
Legal Description: Sunset Park.SID N 75 FT OF LOTS 8&9(0.23 AC)(OR2644I1728)
Property Tax ID#: 2430-501-0017-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CAIvJW1J (a-) _'2&(MX1C dr4mr' W SuS44e, 41 l
44ew
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CONSTRUCTION INFORMATION: f
Additional work tobene orme under this permit–c ec a appy:
HVAC ISI Gas Tank []Gas Piping _Shutters a Windows/Doors
Electric ❑ Plumbing Sprinklers Generator;, E] Roof Roof pitch
Total Sq. Ft of Construction: SIn
of First Floor
❑Cost of Construction:$ �� UtilitiesSewer —Septic i Building Height:
OWNER/LESSEE: CONTRACTORI: `
NameRebecca Moore Name: Paul Verga
Address: 1Y -D`" b/L Company:Versatile Improvements&Remodeling
City: U tve�(� State:!''– Address: 2006 SW Certosa Rd
Zip Code: s%oq,� Fax: City: Port St Lucie IState:FI
Phone No.727 215 3474 Zip Code: 34953 ; II Fax:
E-Mail: Phone No. 77121"5 6040
Fill in fee simple Title Holder on next page(if different E-Mail: virfl@yahoo.com
from the Owner listed above) State or County License: CRC 1330679
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ' }
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: X Not Applicable
Name: Name: '
Address: Address:
City: City: I
Zip: Phone: Zip: Phone: ;1
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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.
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 u intend to obtain financing,consult with lender or an ttorney before
commence work or recor 'n our Notice of Commencement.
u s
Signature of Owner/Lesse /Contror as Agent for Owner Sign ure of Contractor/License Hold
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFCOUNTYOF
The for oing instrumen y�as acknowledged before me The forgoing instrument was acknowledged before me
this�ay of 20 Eby this��day of / 2 20 by
(N a of person acknowledging (Name of person acknowledge )
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(S' na ure of Notary Public-Sta a rida) ature of Notary Public-State lorida)
Personally Known OR Produced Identification " Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
�la��• �o�I . l.aS.
Commission No. (Seal) - Commission No. (Seal)
«" otary public NStiNGRa lotlda. F, ""�"�a-, LASHAHNA ING
RAM-.
Revised 07/15: F Y Comm ate of F Ei '`js*`�*Q Notary Public-State
% Com EXPires Dec �r2A� ( , My Com of Florida
*, ended throix,ugh Nation.F i��24^ ^• "o�' Commission#�FF 7 G OVE
REVIEWS F C TV ZONING-ti ttkljF PLANS VEG' "I0N �� PthTil,R j{�nal of
C ITER REVIEW `r RE—V REVIEW REVIEW REVIE W
DATE ! j
COMPLETE J
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INITIALS
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