HomeMy WebLinkAboutBuilding Permit ApplicationCABL�INFO JUS BE COMPLETED FOR APPLICATION TO BE ACCEPTED L
Permit Number: lJ
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 _i'
PERMIT APPLICATION FOR:
Address: 0 Dk.., lu n)c-, 'Q k- 8
Legal
Property Tax ID #: 2>32 2_ =5
Site Plan Name:
Project Name:
Setbacks Front— Back:
Right Side: Left Side:
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Lot No.
Block No.
— HVAC. — Gas Tank — Gas Piping Shutters Windows/Doors
— Electric — Plumbing — Sprinklers Generator y Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer — Septic Building Height:
Va U0 %J ULOR 13LI L946UU11 M q4.1WV UU ffluru, a nitiLunutu imoxice oT Lommencement is required.
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'CONTRACTOR
Name t
Name: %3
Address:6 -5- D6 1 W K Zia Wdo P
Company: AdUtuye-ku-.16,U�
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ity:.� 304 Q
Address mllo cto e ia r,, z ysig
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Zip Code:Fax:
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City: _�CNN A 0: erc-
Stater
Phone No. 2_,9_Z
Zip Code: _(_ � '4 Fax:
E -Mail:
Phone No. 1 2-2t-/?
Fill in fee simple Title Holder on next page (if different
E -Mail dU,,W,0
from the Owner listed above)
State or County License:
Va U0 %J ULOR 13LI L946UU11 M q4.1WV UU ffluru, a nitiLunutu imoxice oT Lommencement is required.
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UPPEEMEN1A QNST RIIEN"'LAWINFORMATION:g
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
SEATURTLE
Name:
Address:
REVIEW
Address:
REVIEW
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
N •
Your
WARNING OOWN -Your failure to Record a Notice of Commencement may result in yo paying tw "F for
improvern nts to your operty. A Notice of Commencement must be recorded and pqst
c stud on the jobsite
beforethe
irst inspectio . If you intend to obtain financing, consult with lender or an latto ney before'
com nci(n Work or re ording your Notice of Commencement.
Owner
STATE OF Fl.
COUNTY OF
The forizoing instrunr/�nt was acf<nowledgjdl�elore me
this V]Sdayof J--\-CY--f 1 201 ,
Via
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(Namperson acknowledging)
Personally
Commission No.
Revised 07/15/2014
).% - Public - Stale 01 Florida
C 0
dr.ires May 27,201
my - -
Bonded through National Notary ASS
Signature ofContractor nicense Holdek ll\
STATE OF FLORIDA
COUNTY OF
The forgoing instrumept was ac owledged before me
thisday of 20
ir?y
n� CLS �
(Name of person acknowledging) I
(Signature of
Ily Known
of Florida )
......Y ruu"L; - state of Florid
My
234730
COMM.ay 27, 201
Bonded throuMet Notary Avz,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS