HomeMy WebLinkAboutbuilding permit 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:(7721462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: k�
Address: � Y
1 'Del OF+ Pvtre Flom N6 cov of N 05 O 5 42 Os NE iful OF SE "An
es ri ti n F
-
PropertyTaxlD#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Ins} l l ) ke cln� like rang c6cv-
Additional work to Depe orme unclertnis permit-check all that apply:
_Mechanical Gas Tank _Gas Piping _Shutters ✓Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof
Total Sq.Ft of Construction: 11 Sq.Ft.of First Floor:
Cost of Construction:$ l Utilities: _Sewer _Septic Building Height:
Name Name:-
Address:xizn w ilk) 1k Company: MM r' aC &.c db s-�
tFillinfee
State:-�L Address: 1108 Tom h ralr Di
e: Fax: City: Zr¢tian N<.grvo 6.,k state: FI
ZipCode: 3Z937 Fax: 3LI-777- W3U
� � Phone No. 772-337-4470 simpleTitle Holder on next page(if different E-MaiiL LuFcss gait 4tio� _oM Owner listed above) State or County License: .�I1
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
R� ;ems
DESIGNER/ENGINEER: _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 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 Homeowners Association and review your deed for any restrictions which may apply.
inconsideration 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 5t.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrenry 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]obsite
before the first inspection.If you intend to obtain financing,consult with lender or an attorney before
commencingwork or recordin our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
I
STATE OF FIL IDA STATE OF FL
COUNTY OF� _ _ COUNTY OF IQ
The forgoing instrum nt was acknowledged before me The r�joIng instrument was acknowledged before me
this 21daayof. ,y1 Ylf" 20,Lby this 1dayof y)(11FIP 20 -Mby
I in fperson a rwwledging) 0jimeti
e I
l at r i-Star of Florida) ateof Floridal
so 1 oduced identification— Produced identification_
Ty f t Prod c Comm1 -on s'�'•'v"i� ��AEfi +; Bppy�
MYOOLYALCSIONIIFF24M a.! y;s MY IdJAU)SSIONa�49655
W.. E%PIRES',Jur1625,20tB �` EXPIREB.June25,2079
Revised 07/1155/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE HIE]
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