HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: j Permit Number. Q_TT
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 arrow at the e hd of line
Address: 1"D + OL
Legal Description: 14k ,eit �r Li o, iS)K
Property Tax ID #: -Lot No. 17
Site Plan Name: Block No.
Project Name: Do 4e, --
u
1JHVAC Li 15qs Tank F]Gas Piping' W—Shutters
0 Electric 0Plumbing FISprinklers 01 Generator
Total Sq. Ft of Construction:So. Ft. of First Floor:
. f ]
Cost of Construction: $ 4 _lZ,, t?,? I,J - Utilities:0 SewerSeptic
Name
City: V8 Cd 2e(t. T state: Fl --
Zip Code: L,,Y Fax:'
Phone No. Sp -_!r— a 1:2 0 lo
E -Mail: A/Aa
Fill in fee simple Title Aoidir on next page ( if different
from the Owner listed above)
Name:
Windows/Doors
0
Building Height: a 01
Company: C -
Address: 6_rl, 'i 6.:.)a
City: State:
Zip Code: J!ZJ !gl6 Fax: 7
Phone No. Z%2- 41611 -i&C
E -Mail: I -P o", rG a )e!2140 --e-, 0
State or County License: sce- 1,3 t -s-,9.9
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
EER: *.- ", Not Appl!G?ble
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: r
Address: e_4LzF_
City:
Zip: Phone:!
MORTGAGE COMPANY- Not Applicable
Name:
Address:
City: Z I State:
Zip: Phone- /
BONDING COMPANY: Not Applicable
Name: 1 14X
Address:
City:
Zip: Pho.-
I certify that no work or installation has commenced prior to the issuance of a permit.
'1* '
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
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
commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Agept,
STATE OF FLORIDA STATE OF FLORIDA f
COUNTY OF S+ cl_tx_ I COUNTY OF � " A-y—
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this _'%�clay of Cyl- .,j by
20 My this, M (2,A4 201
day of I _
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notaryic- State of Florida
KnownP
Personally Known Produced Identification
Type of Identification Produced
Commission No. �7 0 (Seal)
FPANCESV.JOANs
EXPIRES: October 2g, 2020
�'6'OF FjQS
Revised 07/15/2014 , Bonded Thru Budget Notary SerWces
REVIEWS I FRONT I ZONING SUPERVISOR
COUNTER REVIEW REVIEW
OR
INITIALS
(Signature of Notary Public (Shte of —Florida
Personally Known --�011 Produced identification
Type of Identification Produced
Commission No. (Seal)
V JOANS
MYCOMMISSION # GG 030038
- EXPIRES: Octobei2g,2020
REVIEW NS I VEGETATIREVIEW ON I SEATURTREVIEWLE I MREVIEWANGROVE