HomeMy WebLinkAboutBuildingg Permit ApplicationSUPPLEMENTAL 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 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 thirst inspection. If you intend to obtain financing, cot}srglt with lender or an attorney before
commeyrciyg work or recordi R your Notice of Commencemert /
s
_ Signf 06ner/ Lessee/Agen Sig re o ontrac r/License Holder
STATE OF FLORIDA,�STATE OF FLORIDA
COUNTY OF i f UU AA -V AA-Vro VW COUNTY OF �a/1t VlVCf'
The forgoing instrument was acknowledged before me
this 2a day of 'F(I h k)'Ary , 20 Eby
CM' fflo It
(Name of per acknowledging )
(Signatur of Notary blic- State of Florida )
Persona ly Known OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
The forgoing instrument was acknowledged before me
this'25day of Ff-hrUA r4 __,20 Eby
mo hl eel
(Name of persona knowledging ) I
(Signature f Notary Publi State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
`+►�' PERLY MAY
(Sea*11111111BERLY MAY Co-nmission No.
MY COMMISSION # FF241365 MY COMMISSION # FF241665
ria 1a oma o, EXPIRES June 18, 2019
( 07/ 39"153 Fbrida"oyryge•vx* con, (407y 39b0+53 FbridalloterySery ce.com
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
:co
1 D -A
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 V/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 3-1()2 1`4 A 1 A #,-q02
Legal Description:
-'rand ISle CF NOrt-Y) H�Jt(,1�1i n,��n ISian� Ccn(AnnAA nil)fYl
(Or 2231-)1010) unl F 407 for .�q��� -IU►�1
Property Tax ID #: 2 u-7 - co 1 � - Coo C:I Lot No. 40 Z
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side
DETAILED DESCRIPTION OF WORK:
juppiy and insrai1 50 Yhon
Left Side:
2hCe_m tall A'Jt-e.v heater.
CONSTRUCTION INFORMATION: 1
Additional work to be erformed under this permit- check all a I
pp Y:
HVAC _ G s Tank []Gas Piping Shutters a Windows/Doors
Electric L_r I Plumbing []Sprinklers p Generator Roof
Total Sq. Ft of Construction: S. Ft, of First Floor:
Cost of Construction: $ 8 1O. 0U Utilities:11Sewer Septic Building Height:
OWNER/LESSEE:
Name StcVCn C. L'apian
Address: ;-�10 2. N. A l A t4-102_
City: Fe r t P i e.�- (,-. State: r L -
Zip Code: , S-4 q 4Cl Fax:
Phone No. U311 -- 55 3
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: rY-Al G( MO6le'-4
Company: C)CUtht..V pj �IYYIhin I nG
Address: 40 in q 43 `�/\v e n,_) (--
City:
City: V e v C P, c-,;:) C h State:--F—L
Zip Code: 3 '2-q Lo U Fax: 1 1 2
Phone No. _`11 2 - S L ZA - „c( p,Q
E -Mail: V-'fyl,a SC) Urhe-rnp ivrnhi nc
State or County License: 2 -FOU -1 1 GO J C ' fy,
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.