HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: ,
owl, 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 lin'e
PROPOSED AMPR T
PVEM
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Address: v-cp__
Legal Description:_ `��e-rar6y-1 2 of
Property Tax ID#: —KC)S OM 066 Lot No.-7
Site Plan Name: Block No.
Project Name:
Setbacks Front— Back: Right Side: Left Side:
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CONSTRUCTION:---IN;
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Additional work to be nertormed underthis permit-check all that apply:
HVAC Gas Tank E]Gas Piping Shutters 11 Windows/Doors
Electric 0 Plumbing OSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . of First Floor:
Cost of Construction:$ Utilities:cn Sewer 0Septic Bu ilding'H eight:
CONTRACTOR'
Name'Taa-,� N IS61 4 :3,a(-nAr- 1 c-kel Name: D. T r-k-9&r'060 If-
J — - 1 a, (
Address:- KC6-- Company: FTI- 0 cr-+r,,ca-'( Vic evS' 7�-
City: PAo State: CA' Address: J"?Y0 50-J rJ 1 1-m or& &f--.
Zip Code: 9-2-t5"b-)9')qFax: City:A7�T I-L C4.P-- State: :R-
Phone No. 'K C)I— ('T Zip Code: 34997Fax: 772-3V0-707
E-Mail: Phone No. -7-2 �
Fill in fee simple Title Holder on next page if different E-Mail: 'ku Lq2t,9-1 T--c—A.P
from the Owner listed above) State or County License: �L 13 bo-?-e s-b
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPFLEIUIENTA�CaNSTRUCTION LIEF LAW INFORMATION} ' f
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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 Count 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 Horne 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,perforin 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 nonLl 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.
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Slg re of n /Lessee/Contractor as Agent for Owner SignafiWe of C act r/License Holder
STATE OF FLORIDA STATE OF FLORID.
COUNTY OF A-. bt-c c Lo- COUNTY OF LLC Ct�J
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thiOY"ay of 9 Vl Cts 20 1--7-by this 2.q day of 2011 by
(i _ s cl l�t,�Z3f)c .
(Name person acknowledging) (Name of Odson acknowledging)
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(Signature of Notar Public-State of Florida) (t'linature of Notary Public-State of Florida}
Personally Known ✓ OR Produced Identification Personally Known—LZOR Produced Ildentification
LDATE
tification Produced Type of Identification Produced
Lom8mooNo. Se Commission No. ZLI
r rye. M �SSION#FF 936297
00711 "` ' EXPiFtES:February 22,2020
SymALOMBAR F936294 ;`':
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»•' ` EXPIRES:February 22,2020_
7/15/2Q14 a� am� ?'�'r.�`�
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FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW