HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - — 2-9-12.0 Fr 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 X_
I PERMIT APPLICATION FOR: To Select from drapbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: RWER PARR- UNIT Z - BILK 19 UTE 45 NAP 34-129- S)
(oR ?nG4-//yy2'In58� f
Property Tax ID #: 3 'T4 l 510 - 01-4 ro -000 - G Lot No. 46
Site Plan Name: Block No. � J
Project Name: I - AU C.Y1C
Setbacks Front
Right Side: Left Side:
!Remove old Qw cmc31fiioni unit alnd installl new AG S�Sterl l
3.ro -tons -16 SEF -t2 10 ICvJ. r reskden-+a1 Plrof>ert
L�NHVAC Gas Tank
Electric Plumbing
unoer tnis permir — cnecx a
❑Gas Piping
Sprinklers
a
U Shutters Windows/Doors
OGenerator Roof Roof pitch
Total Sq. Ft of Construction: l S Ft. of First Floor: _
Cost of Construction: $j Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameSpiryia, PGTe1ya Palao gOI VC't
Address: Z.icl alivet�G'
Name: ll
Company: Y Air Cam 10C.
City: at-+ Sall -C Lode State: R.
Zip Code: 34°1524 Fax:
Phone No.95 — $Q — 5
Address: 1g34 U 681mare SAYee
City: Scant LoC�e State: -FL
Zip Code: 341 W it Fax:
Phone No. 7197.- °1195- 3118
E -Mail: RaUDboUgi &tja <3 CC In
Fill 1n fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: !ncIDorQ1YCQle i -oft• net
State or County License: CACI b
It value of construction is ,SZ500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN ERANGINEER: 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 fraying 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 ttorney before
commencing work qr recording ypUr Notice of Commencement. I I
_ Signature of
STATE OF FLORIDA
COUNTY OF
The forgoing instrument w s acknowledged before me
this `Z,ay of fAh , 20 Lby
(Votary Public- State of Florida a
Personally Known X OR Produced Identification V.
Type of Identification Produced
ARM %MGL
`L ...,_
Commission Nol' ,C i7�Iw Its& ISSIONIFF914194
IRES: August 30, 2019
"'+,���aa{0c Bondedt�tBudq�li�'Sei�k�
Revised 07/1512014
F'1
Signature
STATE OF FL
COUNTY OF
The forgoing instrument was acknowledged before me
this ZZ day of PV41%vt-, 20 f--4 by
k btiiI►��
�OKSon.hckp*ledging )
(Signatur.Kof Nhtary Public- State of Florida )
rally Known OR Produced Identification
of Identification Produced
Commission Noll, 9AMARI.S !SA R GIL
f �� * ea 00MISSIONtFF914
EXPIRES: August 3D, 20
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