HomeMy WebLinkAboutBuilding Permit Application.PP LICABLE INFO MUST BE COMPLETED FOR APPLICATION' TO BE ACCEPTED
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Date: -I/ ('7. Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front
Building Permit Application
Commercial
3 ,ld,v &Q-te' av-& v �
Back: Right Side
Left Side:
Residential <-��
L��t G IZ' / Lll� L �'� H- �yscc� f'�P r►s� o � ' `o %%./
Additional work to be perrormea unaer
Mechanical Gas Tank
_ Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ ��
permit – cneck an tnat apply:
_ Gas Piping _ Shutters
_ Sprinklers _ Generator
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic
Name 1n,oka M a FAIV,lA Cara So
Address: ,;G3 �a s4l C,K. J Rd
City: w I lc w odcl Ortst State: ,S
Zip Code: E$2 I✓ O Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Lot No.
Block No.
Windows/Doors
Roof
Building Height:
Name: Curtis so-mmon S
Company:_CAA ��-rtom At'r 5�9+ems
)ivc.
Address: Ike [ S SE �I r I Ia�Q_ rawrn
Dr
City: VoQT !ST UGC_ ,State:
FL.
Zip Code: 34q-521) Fax: 97;
33S ) 96F
Phone No. `772 33,5 -3232-
E-Mail: Ir, SL' t V Gro ) •r.tv,
State or County License: Cfl C 0 5 1 R lO
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if value of construction is 25Kor more, a RECORDED Notice of Commencement is required.
7006 11. _ _,.... . . .
DESIGNI
Name:
Address
City:
Zip:
NEER:
Phone:
FEE SIMPLE TITLE HOLDER
Name:
Address:
City:
Zip: Phone:
U(M- N UEN LAW
Not Applicable
State
Not Applicable
RTUPI
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 recor mg your Notice of Commencement.
Signature of Owner/ Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF ,SZ/ ^-t'_
The forgoing instrument was acknowledged before me
this / day of /)%VZ,ck) , 207 by
�icrtirs
�H irtmcnS
(Name of person acknowledging )
*4 " C t - �' ��
(Signature of Notary Public- Stdte of FI ida )
STATE OF FLORIDA
COUNTY OF J-/.
The forgoing instrument was acknowledged before me
this / day of /s AU -110 , 20_,Z_Z by
Cit (-tI -5 >S�H m me
(Name of person acknowledging)
(Signature of Notary Public- State of Floyoa )
Personally Known OR Produced Identification Personally Known I/ OR Produced Identification
Type of Identification Produced aY ^ Type of Identification Produced `o.,_
ro` .. • •:
CHRISTINE B. ENGLISH CHRISTINE B. ENGLISH
Commission No. F�d',Sy d2U *' e4I)1YCOMMISSION#EE859210Commission No. EEc1�51/,d��i * �)I�YXPIRESSiON EE 85928=
EXPIRES: April 4, 2017 a=
EXPIRES' April 4; 2017
��' EOF FISP Bended Thai BUdQCi NOi21Y SEMCS F.^.F F10� BO:,(I?C ThN BU�Ci N013N SgYIC
RFVIFWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/2014
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW