HomeMy WebLinkAboutBuilding Permit Application i
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 FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential _
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION
Address: d 2 of b '
Legal Description:�i&&.4A jnF�f�� .31 L/_ IST 10LI.03 9a—) 0_)e /211 - 19r:0
Property Tax ID#: 0106-o? Lot No.�
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Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:,
DETAILED DESCRIPTION OF WORKJ.
F
CONSTRUCTION NFORMATION
Additional work toe nerformed under this permit-check a appy:
HVACD Gas Tank ❑Gas Piping _Shutters E]Windows/Doors
Electric 0 Plumbing Sprinklers E]Generator E]Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ , 3�'S.,O Utilities Sewer F]Septic Building Height:
OU4/NER/LESSEE. ..'. .. t.r CONTRACTOR, t U' .. 3
Name L7aui&` (a.ral lDawle Name: o,.r�►,�;Q�
Address: ap TQIIvg? �J+ • Company: T!? l2 t fc ;.of 1F Z-h G
City: Stater Address: 1201 -'V^w fel Hip,are r St"
Zip Code: yq!gy3 Fax: City: State: FL
Phone No. 71 a • aOT• a(4 qS. Zip Code: Fax:
E-Mail: Phone No. __7-2,9 -1'7'3 •G[e b G
Fill in fee simple Title Holder on next page(if different E-Mail: iYIfo
bI'E'f�'fLYi Drs• Co/h
from the Owner listed above) State or County License: " Ll /ed k $'7
(U
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTALCQNSTRIJCTIQIU LIEN;LAWINFC?RMATIQN 1
DESIGNER/ENGINEER: T 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.
St.Lucie County makes no representation that is granting a permit will authorize thepermit 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:roam 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 Comm encemen .
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SignXure of OwnifiLessee/Contractor as Agent for Owner iistu;e 'tractor/License Holder
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STATE OF FLORIDA STATE OF FLO IDA t �
COUNTY OF S T L(Act a COUNTY OF ►.uU J2.
The forgoing instrum nt was acknowledged before me The for ping instrument was acknowledged before me
this day of �t^r.) C 20 /7 by this day ofi i L 20 f by
7 j 1 Ale M
p. '' Itl'b kvl
(Name perso acknowledging) (Name o€ er acknowledging,
gershally
r of N Public S e of Florida} (S. ture of Notary Public-State of Florida)
Known P d c I' if ti er onally Known f ation
dentification Pro ce I y e of Identification P N
'-Niter rUD119^wirof Mains' r0 of Fk)dda
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:$ Josa Shane Alberico Q ' a Shane�Ipe�
Commission No. n ,* My6B,81i)tsion Gg o208fi9 Commission No. Expires 08y18/20Eq 020879
oip kres 08/18/2020
Exp
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER , REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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INITIALS