HomeMy WebLinkAboutBuilding 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 arrow at the end of line
PROPOSED IMPROVEMENTOCATION:
Address: -' (� L��' I' � 06z -
Legal Description: 2-e- (:,c r -'V ✓ $'QAQ- 0V,
k/
Property Tax ID #: 33.7i / 803 Lit;, 58 -000 J Lot No.�
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Ke -i1OLk �e V\J0 + L -VO QCV1 VJa-AeX t IN)C
CONSTRUCTION INFORMATION:
Additional work to, r orme —under this permit —check ail t appy:
HVAC Gas Tank ❑Gas Piping In Shutters F—] Windows/Doors
11 Electric IN Plumbing Sprinklers 06enerator 0 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ ),300
SFt. of First Floor: _
Utilities: Sewer 1 _i Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name v1" . 1 V\ °�
Name: Vd 10
Address: 7�
am �OV)
r
Company: ��� It Jil C -
City: F3 L. State:Address:
Zip Code:DRO
� d Fax:
Phone No.
ivy 11
y� r ,.
City: i3 LState: F�
Zip Code: q T6,�-7 Fax:�7�
Phone No. -77�_ t / -- 0010
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above!
E -Mail: I� 1V1C. �� U • 4 ��
State or County License: if
11 value v, cvnstruLuon is ?c5uu or more, a KtL.UKUtu Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 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 you intend to obtain financing, consult with lender or an attorney before
commencing work or cecordina vour Notice of Commencement.
Signature of Owner/Lt�s6e/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The for oing instrunAQt was acknowledged efore me
this day of Jf-C,�".W 20 _by
(Name of p son cknowledgin
(Signature of No r bl'c- State o Florida )
J
Signature of Contracts
STATE OF FLO
COUNTY OF
)i616cense Holder
f)
The for ping instr ent was acknowledged before me
this day of Filo �� 20 by
Personally Known OR Produced Identification Personally Known IOR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.
'53
Revised 07/15/2014
IOHI,t1M�f1iAYMONDFITZPATRICK Commission No.
MY COMMISSION # FF233682
FYPIRFS Mav 21.2019
140 / 1 3So8-0' S3
FITZPATRICK
MY COMMISSION # FF233682
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS