HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED INPROVEMENTLOCATION:"
Address:U 0 - e
Legal Description: AA 5 L"e
/ �
1n
Property Tax ID I "1/G' O0' 0I5 —000-5
Lot No.
Site Plan Name:
Block No.
Project Name: tri vi n a- 0 �y
Setbacks Front Back: Right ide: Left Side:
DETAILED ESCRIPTION OF WORK: //
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P.�1, P.0 1�4�� Ct CP-ytiP.h
CONSTRUCTION INFORMATION:
A001tionalworktopeperformed under tis permit -check all appy:
In ❑Windows/Doors
❑HVAC i�Gas Tank Des Piping _Shutters
I-
❑Electric LJPlumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt, of First Floor:
D� Septic Building Height:
Cost of Construction: $ Utilities:cn Sewer[:]
OWNER/LESSEE:
CONTRACTOR:
Name
Name: e-
Addres :
UI
e.
Company:
ML
City: V State: �L
Address: i0
City:I)TDIM(-000
State: FG
Zip Code: 3 Lf Fax:
Phone No. 772 ro J 3-
Zip Code: 5-5 Fax:
7 O
�21I % 72
E -Mail:
Phone No. z
Q
U
Fill in fee simple Title Holder on next page I if different
E -Mail: 1M t S
Q.UIi
State or County License: L FC
I Y Zs
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name: — -- ` _
Address:
City. State:
Zip: Phone:
MORTGAGE COMPANY: _Not Applicable
Name:
Address:
City: State:
Zip:Phone:
Name: — -' .. .... I ovi'll COMPANY; Not Applicable
Address: Name:
City: Address:
Zip: Phone: City:
ZIP: Phone:
OWNER/ CONTRACTOR AFApplication plication is hereby made to obtain a permit to do the work and Installation as Indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St, Lucie County makes no
----- •'""� Zowners Association and reviewyouF&W?orany reitrictio mayrestrict or Prohibit such
In consideration of the gra ing of this requested permit, I do hereby agree that I will, In all resets, Perform the work apply.
in aaordance with the app ved plans, the Florida Building Codes and St. Lucie County Amen meats.
The following building perm applications are exempt from undergoing a full concurrencyr ie w: room additions,
accessory structure swim ing pools, fences, walls, signs, screen rooms and accessory use to another non-residential use
WARNING TOO NER: our fai re to Record a Notice of Commencement may result in your P Ing twice for
improvements t your p pert Notice of Commencement must be recorded and poste n the ce for
before the first i spect(o . If yo i tend to obtain financing, consult with lender or an attor a before
commencin wo k or reco ding
OF
STATE OF FLORIDA
COUNTY OF
The for ing instru pry
this day
n as a knowled ed before me
The fp oing instr
of -,20�bY
th^sL day of 'I
eqt
IV
wasacknowled8ed�before me
)Yll 20j(j,(by
f9
person
Personally Known -)W—_ OR produced Identification__ Personallv V
ype of Identification Produced y Known OR Produced Identification
Type of Identiflcatlon Produced
Commission No. ,ti:^%�;:.. .cu,mcannrcncecurnc
ommtssion No.
MY COMMISSION #FF12071
`•!oda„ ' "' 'i �dY COM.MI"SIGN VFF120712
Revised07/15/2014 tEW12WL1s2 FiaruaNatar Ss Nlce.cOm .zoe EL'S ev
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