HomeMy WebLinkAboutpermit applicationAll APPLICAL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1l g, l 1 Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 452-1578
PERMIT APPLICATION FOR: 4,
Address: <�bbD-
Building Permit Application
Commercial Residential
- L�KQ- LKe-
Legal Description: � � l�- �R '`� '�' "� t4- Z
Property Tax ID#: C) - y -- okak-i ` �� -7
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No._
Block No.
Mechanical _ Gas Tank _ Gas Piping — Shutters _ Windows/Doors
Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
Sprinklers — Generator
Sq. Ft. of First Floor: _
Roof
Utilities: Sewer _Septic Building Height:
Name Name: +5
Address: C)�- Company:
StateF( rr Address: b � � -7
Zip Code: _�9'�5 l Fax: t`A City: 1 . KO—Mc'—p- State:.
Phone No. ? a .5 3 A -S -D I Zip Code: [ S Lk Fax:
E -Mail: i-- J-+ Phone No 02-7 - 9 3 7 7
Fill in fee simple Title Holder on next page ( if different E -Mail ft C -Q0 ; n
from the Owner listed above) State or County License+ ?
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If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
of Applicable
Name:
Name:
Address:
Address:
City: State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _of Applicable
BONDING COMPANY:
LIGot Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
ASIA lr►ICoI rr%w1Tr%A w
- V`Ix/ 6.11Iv 1 7% � vr[ Arriuvi i -.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 inspe. ' n. If you intend to obtain financing, consult with lender or an attorney before
commencing wor_ " r rcling your Notice of Commencement.
Owner/ Lessee/Agent
of Contractor/License Holder
STATE OF FLORI InA 6'� STATE OF FLORIDA.'
COUNTY OF • �►-c �; COUNTY OF ���.
The forgoing instrument was acknowledged before me
this 1)6 day of "rte_ 201:] by
(Name of person acknowledging )
(Signature of Notary Public- State of
S BRINA L. BUCK
Personally Known to' OR Pro
Type of Identification
Produced
Commission No. � 15
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
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te:3�6Allufi'3i
E of
The forgoing ininstrument was acknowledged before me
this .', day of 201 by
(Name of person acknowledging)
s
(Signature of Notary Public- State of Florida
PersoP`alfy�I�nowlA ��/ OR�Produce d,Ftie is SA$Rl�j�°`�•
R•.
Type of Identification ���yFabruay 0y ;'
Produced
Commission No. I — F 1 ! 5 -33 7-� ,' 1P,
ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW