HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l
MAY 20 i( Permit Number:
Date: M'I
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:
Address: 1ss ?ARK
SeNEro 6-&-r r� ?r. - r. Luc.►
r�E
Legal Description: -Jer, PARK yr -7 Loc-oc-K 11A La -r $
Property Tax ID #: 0 r 0 ���� Lot No. g
Site Plan Name: �oM �1» S 49ft KENS V01E Block No. JA
Project Name:
Setbacks Front Back: Right Side: Left Side:
O TNs-riuu.AT►oPj Of 2 d , OF (D' i'6*cy VeN ce W ty Q 14e
6 -m. . 0w -rAE t R", O cST
S►c Q1Nb log -0, rag0,4 rAe 14 1 EPST S►VG
ional work to be pertormed under this permit— check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ Zoao . oa
,Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Building Height:
OW'N'ER/LE�SRE
CONTRACTOR:
Name Tri. , :ti._: A►E= E E
e:
�ddr1ss:158::-Son1ETa ieod.RTi.
Compan k
<sr U6 State: F�
:rAddrress
ip;Code: 30WFax° °'
Y
City: State:
Phorie°No. 106 - 5a�1 h
Zip Code:
E-Mail:-1P_y1Sh-6(JS a GMPIL . 110M
Phone No
E -Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
EMS MANTRONSI.-
DESM—GNER/ENGINEER: Applicable
Name:
MORTGAGE COMPANY: N6t*A6r)licable
Name:
Address:
City: State:
Zip: Phone—
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING- COMPANY: Not Applicable
Name:
Address:
City:
Zip: — Phone:
OWNER/ CONTRACTOR AFF8DVIT:Application ishereby made toobtain apermit todothe work and installation asindicated
|oer��that nnwork orins��Uo�onhas commenced phortnthe �suanceofopemn�. '
St. Lucie h i ith structure
which_.... . "=.o. / nron prohibit such
structure. P��seconsu�v��h�ourHomeOwners�p���t������v�w'---deed~~~~~'~''^^� ���"''``"',"""
. your roranyrest�cUnns`..ichmay apply.
In consideration of the granting of this requested permit, I do hereby agree that'l will, in allrespects, perform the work
inaccordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing ofull 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 tmRecord a Notice otCommencement may mesmlt'im"-/wr paying twice for
improvements toyour property. ANotice of Commencement must berecorded and posted onth'obsite
befmretha�rstinspection.|fyouintendtnobtain�naDcin��consu|tvvithlenderora��-ttmrnGybee�'-
re
commencing k or recordingNotice of Commencement.
:fff� 0—
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA,� STATE OF FLORIDA
COUNTY Of
COUNTY OF 6ij-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this L4 day of Me� 20ja by this 'i day of 20 1-) by
(Name of person acknowledging) (Name of person acknowledging)
ISIgnatbreofNotary Public- State ofFlorida
�� cVNotary Public- State of Florida
t
Personally Known ORProduced Identification V" Personally Known _______ORPnoduced|dentificatod~~^
Type of Identification Type ofIdentification --
Produce | Pnoduce
Commission No. P17 of I?
REVIEWS
RECEIVED
(Seal 6Y WHEATLEY
Notary P61ilic - State of
Tdoon
No��PmN� --'=
, 'D��m