HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r�
Dater /' ' 17 Permit Number: 7REC V
Building Permit Application
Planning and Development Services JUL m 7 2017'
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 1 /
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: D _rleelotj R0,110V Lope, I_
Legal Description: SOl/OP1 r1C, I Cl(� ple• phase,- --chre-e— 21 pck— 72
Property Tax ID#: `7 — 70S (A 0 r C)d 0— o Lot No. '2 f
Site Plan Name: _ _ Block No.
Project Name:
Setbacks.. Front Back: Right Side: Left Side:
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itiona work oe e orme un er t is permit—check a appy:
HVAC 13 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric Q Plumbing FlSprinklers FIGenerator g Roof Roof pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
D•OD
Cost of Construction:$ s Y� Utilities:0Sewer 0 Septic Building Height:
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Name. t,Jle(�. Name: 11M WC, �
. 'sfe ! +Xba Company:Address:3J80o ieCity: ri- _f+. c�rav+Tc»f� C
Address: 1 S /VI cerkof AVe.>
Zip Code: _V qS Z Fax: City: • Pie-Ce, State:,_
Phone No. Zip Code: 2(f Fax:772 (46P- 95U_
E-Mail: Phone Not 7-7,— 6 -1686
Fill in feesimple Title Holder on next page(if different E-Mail: tRwr�"Cii ��PrY�t 6. 1'hd`r��com
from the Owner listed above) State or County 'cense: o
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I f value of construction is$2500 or more,a RECORDED Notice of Commencem nt is required.
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DESIGNER/ENGINEER: w 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 Nome Owners Association rule§,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:Yoder 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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Sig Lure of Owner/Le ee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDAe,t STATE OF FLORID
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thlsJ*n day of 3�J __, 20.176y this-'146 day of 20 )–+by
{Name of person acknowledging) (Name of person acknowledging)
{S gnature of Notary P Iic-St ftttzl<� (Signature of Nota ublic-State ofl-lodda
Personally Known bR P i fifI ion Personally Known �. OR Produced Identification
Type of Identification ProcB�ceda 2�o• o Type of Identification Produced
Commission No.
Commission Na. ani (Sea Commission � ,��' —,� .� •�OM s'••. 9
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION -SEAi4� E 0• '"GROVE
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DATE
COMPLETE
INITIALS