HomeMy WebLinkAboutBuilding Permit Appliation.PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - Cn - - I
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Permit Number:
Building Permit Application
Commercial Residential
Address: $ �i t C12. �.C�� D(L
Legal Description:
Property Tax ID #: ;3LAa b - 9 byl - Op- ( Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Li lie- For ,
I.(e 3 To
0en-E v
Block No.
amonai worK xo oe perrvrmea unser mis perTnrt — cnacK an inaL appry.
✓Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor: —
Cost of Construction: $ 3 6?lo'� Utilities: —Sewer —Septic
Name
Address: qS I' i o 'S'r�nn Q2
city: Fbc' - . � . u L e State: EL,
Zip Code: J Fax:
Phone No. 11JIQ-
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Building Height:
Name: &urtts SQ.vnrnon
Company: CiA!<-rpm Ur 5�,stems IIIic
Address: l!e l S S E 'I i I( a -,_Q r eft D/-
City: 'Po Lu
7 ST c % State: �L
ZipCode: 542 Fax: `17a 335,
Phone No. 77,a 33,5 -3a3'2-
E-Mail:
3a32 -
E -Mail: CkLsta4T Sti s V_ Co I -c-M
State or County License: CAC 0 5 1 R IO S �
if value of construction is 25Kor more, a RECORDED Notice of Commencement is required.
ISH
05254G
]21
1wicse
5UPPLEMEN I AL C;UNS I RUC I IUN LIEN LAW INFUKMA I IUN:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address: _ _
Address:
_
City: _ State:
City:
Zip: _Phone:
_State:
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.
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 1 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 exemptfrom undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARN ING 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.
--
::�Y
s
Signature of Owner/ essee/Contractor as Agent for Owner
Signature of Contrac or/License Holder
i
STATE OF FLORIDA r
i
STATE OF FLORIDA ('
COUNTY OF
COUNTY OF
i
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me i
this day of :7�,1L 20 Llby
this / day ofy /LQ-, , 20 by
- Cru r ti S � fit mvY� S'
v
Liu IZT 15 � 0 m vV)y n S
(Name of person acknowledging }
_
(Name of person acknowledging)
/tL
(Signature of Notary Public- State of Fl a }
(Signature of Notary Public- Stat of Flori
Personalty KnownOR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced_
Type of Identification Produced
/' p CHRISTINE BENCit�$Himission
Commission No. lT1 G1 OU t!j
lTl fij`I (? c
No. V;
IN
rdgY
o
* * MY COMMISSION X�G
052546 N
_.... _ _.�^a o� EXPIRES: AW ,
_
Pg�"6®P Banded Thru Budget Notary
�`
2021 e p4t"+ ' r {
t►R. CHRB ENGLISH ,3s.
Servitee t� .• '•-,
MY
Revised 0 7115/2014
* * COMMISSION 0 GG 052546
EXPIRES: April 4, 2021
PLANS VEGETATION SEATURTLE I MANGROVE
REVIEWS
FRONT ZONING SUPERVISOR 1
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS i
ISH
05254G
]21
1wicse