HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INPO MUS BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: ^�
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential Y
PERMIT APPLICATION FOR:
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Name hAtWuA 14
Name: `5&W"V-A -Atl
Address: 31olo MU1r& P11V7=
Company:
Address: 1,106 MUVA, riziuc-
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fi PaS�ED INPROVEMENT�L®CATIC?N
City: Yp1'� Meyce State: F1
Zip Code: 'H 9 bZ. Fax: AA
Phone No 'ii2.'414. ZOIC
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E -Mail VIOAJOV yz'-A1><oww
State or County License DWLW %i t, or✓
Address: -IuC7 N1turA 1/fLw�
Legal Description: �t6Vem- LQIc1= I�Aux ItyIocIL 12 Lole! /24
Property Tax ID #: 2-427. 603. 01'67-. 000.7' Lot No. 2`I
Site Plan Name: _ I -j1 JyrQ LAKF �aVK Block No. 17-
Project Name: via 017 -
Io -Setbacks Front 25 Back: LA6 Right Side: Left Side:
Qour tje.J Cou rete atr WVV Zn �4 2a X . 5" TV it-W-
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator
_ Roof Pitch
Total Sq. Ft of Construction: 480
Cost of Construction: $ 20000 °Q
Sq. Ft. of First Floor:
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Utilities: Sewer _ Septic
Building Height:
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Name hAtWuA 14
Name: `5&W"V-A -Atl
Address: 31olo MU1r& P11V7=
Company:
Address: 1,106 MUVA, riziuc-
City: r-00/ PICYCr- State: FI
Zip Code: "!74'187- Fax: lua.
Phone No. '7?2 *1%o4 2.o ID
City: Yp1'� Meyce State: F1
Zip Code: 'H 9 bZ. Fax: AA
Phone No 'ii2.'414. ZOIC
E -Mail: IV�I�ANl7 12 `A�lDD.Lt�M
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail VIOAJOV yz'-A1><oww
State or County License DWLW %i t, or✓
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
St1'PP�LEN`IIENTAL C®NSTR�l1�CTl®N• LIi�N
INFORMAl'I®►N:
.LAIN
Signature of Contractor/License Holder
DESIGNER/ENGINEER:
_ Not Applicable
STATE OF FLORIDA
MORTGAGE COMPANY: _ Not Applicable .
Name:
The for ging instrui e t was acknowled before me
this 2by
The forgoing instrument was acknowledged before me
this day 20_ by
Name:
Address:
Address:
City:
State:
e2nature of Notary Public- State of. Florida )
City: State:
Zip: Phone
Type of Identifi ion„ �
Type of Identification
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: Not Applicable
Name:
, m. Explros May 2y, �911�
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Name:
Address: -
REVIEWS
FRONT
Address: ���
City:
PLANS
VEGETATION
City:
Zip: Phone:
Zip: Phone:
COUNTER
OWNER/ CONTRACTOR AFFIDVIT: Application 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 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 our Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as.Agent•for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA C`L
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STATE OF FLORIDA
COUNTY OF
COUNTY OF
The for ging instrui e t was acknowled before me
this 2by
The forgoing instrument was acknowledged before me
this day 20_ by
y of
of
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Nto Public- State of Florida)
e2nature of Notary Public- State of. Florida )
Personally Known OR Produced Identification i
Personally Known OR Produced Identification
Type of Identifi ion„ �
Type of Identification
Produced :,o�pavnLo A UFP '
Produced
o ary Public . Stato of Plerlda
Commisslon
Commission N 9 ' Q: (`Sb4730
Commission No. (Seal).
, m. Explros May 2y, �911�
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REVIEWS
FRONT
.W .
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
-MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014