HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETE
D FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Ir •
- 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 IMPROVEMENT LOCATION:
Address: ` llo 5e rC,�w 0; (,J4
r�
A je 1'�� t��- f �3
Legal Description: ! vii ~0,,-
4 `��� 3q
PropertyTaxlD#: 3`ICI`�3o'vCJ
`r�Dd�s Lot No.
Site Plan Name:
Block No.
Project Name: -;e C'—
rr
Setbacks Front 2— Back: `f
cr r
Bight Side: ` LeftSide:
DETAILED DESCRIPTION OF WOR
CONSTRUCTION INFORMATION:
Additional wor to Be perrormeU under t
❑_
espermit-cec all appy:
)
IJ Shutters []Windows/Doors
HVAC Gas Tank
Gas Piping
11 Electric Plumbing
Sprinklers D Generator L1 Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
[I D Height:
Cost of Construction: S 04 `
Utilities: Sewer Septic Building
OWNER/LESSEE:
CONTRACTOR:
Name lba+'_'C_ 14 e--f -
Name: 4e (ru-'�
4"' SG l(G 11114
Company:
Address:
City: C S L-
State:
Address: 7,Eo6 5r] 06v a J AJe,
City: CS L- State:
Zip Code: 3gg83 Fax:?'*
Phone No.
Zip Code: 3 Fax:711-47`�
Phone No. ?�Z - �7 2-3,�S
E-Mail:
Fill in fee simple Title Holder on next pag
E-Mail: ;
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN1ER/ENGINEER: � Not ppllc able MORTGAGE COMPANY: _ Not Applicable
Name: name:
Address: Address:
City: State: Cite: _ — State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not pplicable BONDING COMPANY: Not Applicable
Name, ;name:
Address: Address:
City: City_
Zip: Phone: Zip: Phone:
I certify that no work or installation has coma
St. Lucie Counter makes no representation that
which is in conflict with any applicable Horne i
structure. Please consult with your Home Owr
In consideration of the granting of this reques
in accordance with the approved pians, the FI(
The following building permit applications are
accessory structures, swimming pools, fences,
WARNING TO OWNER: Your failure to I
improvements to your property. A Noi
before the first inspection. If you 'inter
—Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY QF_.__
The forgoing instr Usr1 nt was acknowledged
this day of Dri q 0.
4
G#''aL- / /�/ L
of person acknowledging)
C -1
of Notary Public- State of
Personally Known _ "X _ OR Produced
Type of Identification Produced
Commission Not
Revised 07/15/2014
prior to the issuance of a permit.
granting a permit will authorize the permit holder to wild the subject structure
'nets Association rules, bylaws or and covenants that may restrict or prohibit such
s Association and review your deed for any restrictions which may apply.
I permit, I do hereby agree that I will, in all respects, perform the work
Js Building Cozies and St. Lucie County Amendments.
tempt from undergoing a full concurrency review: room additions,
ails, signs, screen rooms and accessory uses to another non-residential use
card a Notice of Commencement may result in your paying twace for
e of Commencement must be recorded and posted on the jobsite
to obtain financing, consult with lender or an attorney before
_ice of Commencerneot..
me
MA
Signature of Contractor/License Haider
STATE OF FLORIDA _
COUNTY OF -2 " L l
The forgoing instrument was acknowledged before me
this 13 day of 1-C�2 ✓-�, 20 by
(Name of perso anckn.owiedging )
(Signatu4of Notary Public- State 6-1 Florida )
Personally Known X- OR Produced Identification
Type of Identification Prod
kn No.
u
KIRK ARI KATZ
' = 4t&MISSION #FF0449
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EXPIRES August t2.2077
(407) 39&0153 �T,. Finridal�otary esv�ce.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
KIRK ARI Ty
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MY COMMISSION FF044`�24
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(407) 39B-01
FlorirlallotaryService.com
kn No.
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KIRK ARI KATZ
' = 4t&MISSION #FF0449
''"fEOFf�oP„
EXPIRES August t2.2077
(407) 39&0153 �T,. Finridal�otary esv�ce.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS