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HomeMy WebLinkAboutBuilding Permit ApplicationALL AP1)LICAB 4E INFQ MUST IBE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:- t Permit Number: . Building Permit Applicati©n Planning and Development Services Building and Cade Regulation-Division - 2300 Virginia Avenue; Fort Pierce FL 34982 COrnCTlerCial Residential Phone: (772) 462-1553 Fax: {772) 462-1578. To click arrow at the end of line PERMIT APPLICATION FOR;' . " Select from dropbox, +xr �t. ^GYlYY+Y.Mn YS v- „1..:: _'!"" 3"Y4sk"r :•i` rn �"Yi"i t' ,.'• 'fH'`�.�•3�^�'*K„',+9 Y.i y�qi +t','i !E-�E-, i�tt��Y'�'.'�`i }:§fiI .. ���^F�JS �`.v§"�- �'�Q :l.��ih t';.11. v; i� s ,. I.�){�9L; l.t C �.«�?y to :1`fy1 �'�..#'. t�§) [",kr x. �,1. .�,{.,'J+II.3: 1r2:,;.7P �.�n) .#r.'f axr ;.+l..•1 r, s.. � n rP' :�L'rtE•-.t,.r! t ii' i � �h,.` �2 : .. �1 �1 1 `I9 "i! - '�Y 1 E I}a'-.. is) ), k,;� ri i}F..'i `., f7�f v:.i1'•i�1 .�lS�-. i t t j ! .�FG t'e. 1.4: Ef. , },j�1/3I 4�O ti<. ��05 tf ✓-( �,p F.(� �J it� � 43 tFR' i S ;� rS�t k ,Yy�}:. 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City:( �%jiii� State: Address:©oj �'E iu1066Y-_c Zip Code: ! Fax: City: �/Q �, %c�/ State E4,_ Phone No.` V/3! Il Zip Cade: �j�5�- _ Fax: 77�-335 E-Mail:. Phone No, eZ- Sb Fill infe# simple Title molder on next` page ( i'f different E-Mail: .'Yft }aiie drn d from the Owner listed above) State or County License: If value of construction is $2500 or more, a RE.CORC;fD Notice of Commencement is required. r ' r VENU " NEIR/ENGINEER; Not Applicably Name: Address. C". State Zip- Phone; FEE SI—Mhc TITLE HOLVERe Not Applicable Name: Address: cityi Zip: P_honi:_ I ceftify that no work or lnsEallat[on his commenced prior to the issuance of a permit. St; Lutie County makes no 'representation that is gr2hting a ermit 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 dead for any r#strictions which may apply. Inconsideration of the granting of this requested permit, I do hereby agree that I will, irs all respects, perf6tm 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 ful(concurrefty tevieW: room additions, accessory structures, swlmming Pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER; YOilr failure to Record a Notice of Commencement may result in Voiar paying twice for Improvftents to your property, A Notice of COmmentement must be recorded and posted ori th'ejobsite before the first inspection, If you intend to obtoih finoncIng, Consult With lender or an attorney before comn,w ving work or recordiniz 'your Notice of Conimencarnanr. !"Signature of Owner/ STAT� OF FLORIDA C15UNTY OF S* The f grpN6, ng instrument was.acknowledged before me this, y of _AQ -10— L '921- WA 6h. (Name of person acknowledging) (Signature of Notary Publit- State of Florida Personally Known _.,__OR Type of IdentIfIcation Produrei Commission N6. NcUty Poft $&% of kxJ0 MY COMMMim FFOWVA Revised 07/15/201 of e-7pia, 22M REVIEWS. IFRONT I ZONING COUNTER Rl5vIEW COMPLE INITIALS I 'd U86'ON ature STATE OF FLORIDA COUNTY Oim=CI _e-, The forgoing tristrurneAt Was acknowledged before me I this 31%av AA&L 20 (I—q by (NaMLI of person ackribwlec� (Signature of Not# Public - State of Florida) Personally Known _)C_. 09 Produced IdentifIcaklo.n 'type of Identffleatlon Produced Commission No,WT k Ivry Pu* S*R,q eiplftcuiawzi• 5UPERVISOR I PLANS EGETATI5A TURTMANGRO REVIEW REVIEW I VREVIEWON I5 REVIEWLE I REVIEWVE ONIJ00d IVNIMO UZI LIN MORTGAGE COMPANY: Not Applicable Nato-, Address: City: -State- z I p: 7— BONDING COMPANY: Nlot'Applicable Mime.• Address,, Zip: Ph.6nel I ceftify that no work or lnsEallat[on his commenced prior to the issuance of a permit. St; Lutie County makes no 'representation that is gr2hting a ermit 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 dead for any r#strictions which may apply. Inconsideration of the granting of this requested permit, I do hereby agree that I will, irs all respects, perf6tm 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 ful(concurrefty tevieW: room additions, accessory structures, swlmming Pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER; YOilr failure to Record a Notice of Commencement may result in Voiar paying twice for Improvftents to your property, A Notice of COmmentement must be recorded and posted ori th'ejobsite before the first inspection, If you intend to obtoih finoncIng, Consult With lender or an attorney before comn,w ving work or recordiniz 'your Notice of Conimencarnanr. !"Signature of Owner/ STAT� OF FLORIDA C15UNTY OF S* The f grpN6, ng instrument was.acknowledged before me this, y of _AQ -10— L '921- WA 6h. (Name of person acknowledging) (Signature of Notary Publit- State of Florida Personally Known _.,__OR Type of IdentIfIcation Produrei Commission N6. NcUty Poft $&% of kxJ0 MY COMMMim FFOWVA Revised 07/15/201 of e-7pia, 22M REVIEWS. IFRONT I ZONING COUNTER Rl5vIEW COMPLE INITIALS I 'd U86'ON ature STATE OF FLORIDA COUNTY Oim=CI _e-, The forgoing tristrurneAt Was acknowledged before me I this 31%av AA&L 20 (I—q by (NaMLI of person ackribwlec� (Signature of Not# Public - State of Florida) Personally Known _)C_. 09 Produced IdentifIcaklo.n 'type of Identffleatlon Produced Commission No,WT k Ivry Pu* S*R,q eiplftcuiawzi• 5UPERVISOR I PLANS EGETATI5A TURTMANGRO REVIEW REVIEW I VREVIEWON I5 REVIEWLE I REVIEWVE ONIJ00d IVNIMO UZI LIN