HomeMy WebLinkAboutBUILDING PERMIT All 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 Ft 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ✓
PERMIT APPLICATiON FOR:
Address: 2�-n� Q Y^l( � �l Y'� �_.P 1-
T-. Sq`Y y
Legal Description:T1 MWB�b[- GS I I' 7 C-� L T 2-9 (or tW.- IQ-? �
Property Tax ID#: tj0 Lo-o (o-j'Z-- cm Lot No.-
Site Plan Name: Block No-
Project Name: ' r mou
Setbacks Front Back: Right Side: Left Side:
znsla l I like 6c llko- ! tJ(_v e c400r-
AdditionalwoItobe-pepormed under this permit-cleck all that-apply:
!
____!Mechanical _Gas Tank _Gas Piping _Shutters ✓ Windows/Doors
—Electric _ Plumbing Sprinklers _Generator Roof
Total Sq. Ft of Construction:h Sq. Ft.of First Floor:
Cost of Construction: $_ -I Q(' Utilities: —Sewer —Septic Building Height:
Name ?AAAZS i PY_10CP Name: 16r ,nna
Address: !L"�"1 C.,r f�r�Q L._n Company: M01 J rA=rise ooP �c,rf � +r
City: E,c y }� �CQ State: Address: 005 -Tom ahaa]lr tar
Zip Code:W Fax:_ N City: .1-ndiaA garbyur &--c-ti State: rr
Phone No. -1-I 2.-- 9'74-° L4:LO Zip Code: 32-1?,*37 Fax: 32-1-777- yz3q
E-Mail: yU I A Phone No- 7?2-337-1/y70
Fill in fee simple Title Bolder on next page(if different E-Mail: Lulrss ccut�a�. -vas,,•,
from the Owner listed above) State or County License:
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
to
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.
5t.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
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
commen n g work or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLOR STATE OF FLO A
COUNTY OF �\l o Vd COUNTY O'F _ I' f
The forgoing instrum was acknowledged before me The forgoing-rnstru t was acknowledged before me
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Revised 07/15/2014�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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