HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Plonning 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:
Address: L+Lc VVel, iw T1
l T1"•Legal I r I
Legal Description: �L*cVN Por k Ulld_L h1L2Z> LL+� jatp V-t)j (S)(OV 'n-1�r_
Property Tax lD#: Lot No.
Site Plan Name: 1 �I Block No.
Project Name:�l�{C � 1 )uVviolla
Setbacks Front Back: Right Side: Left Side:
ftislall like For fake aLuan.e door q)47
Additional work o be performed under tnis permit-check all that appy:
_Mechanical —Gas Tank _Gas Piping _Shutters ✓Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 1,I Utilities: `Sewer `Septic Building Height:
Name iName:_ W L-A
Adss: Company: mmJE rize oc
Acid,
City:
Qxr r
State:l L Address: i(015 7omahaw� �s
Zip Code: J Fl!a++x:�l/A� City: 7rdi.n l�arf�a ge.ch State:-Fl
Phone No.�-I-i2� ]±L4�L�1 Zip Code: 32937 Fax: 321-777- 423q
E Mait:_N�th _ Phone No. 772 337-q'170
Fill in fee simple Title Holder on next page(if different E-Mail: (ufcss 4un A kh oma.- inn
from the Owner listed above) State or County License: j
_ I
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not ApplicableY
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 the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or an9covenants 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.
L s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLO$�D),/l�� � STATE OF FL03►pA_ _�r�
COUNTYOF� 1�11Qrd COUNTYOF 1�CV
The f oin Instr ent was cknowI d ed.S�efore me The forgoing instr ment was acknowledged before me
this day of 11ra . 20 LLby this qday of F.� V ,201by
��n��a L�ctes �Ixaur�nai�+r es
-(Name of pers acknowledging) (Name of persona owledging)
( at r f N u ic-State of Florida) ( gna ic-State of Florida)
Typeof _�OR P o .Known OR Produced Identification
Type of Identifcation Produced y of ldep. n Produced
-. MFXPIPES June2,2 fin'"'/ / gyil
Commission No •1 .�x(bealY.XPIRESS01 #F,2019 C mission No. a E
'-?....x. �,,e.atnNrsuyaueiKum i--'
R...• � Mt.RRevised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANSVEGETATION SEATURTLE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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