HomeMy WebLinkAboutbuilding permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
i Building Permit Application
Plonning and Development Services
Building and Code Regulation Division /
2300 Virginia Avenue, Fort Pierce FL 349S2 Residential ✓_ _ __
Phone: (772)462-1553 Fax-. (772) 462-1578 Commerciali
PERMIT APPLICATION FOR:
Address:
38 �O
Legal Description:
escription:
Lot No.—&F--
Tax ID S� J�
Property Block No.
Site Plan Name: \
Project Name: ,�
Setbacks Front__
Back: Right Side:�— Left Side:
J
itiona wor to epe orme under t ispermft—c ec all that apply-
/Windows/Doors
Mechanical _
Gas Tank Gas Piping —Shutters —
—
Generator Roof
_Electric _Plumbing _ Sprinklers _ —
Sq. Ft. of First Floor:
Total Sq- Ft of Construction: Q —� —
Cost of Construction: $ ��- I� Utilities: _Sewer Septic Building Height:
Name: Oryw In � pp � �r�<<, o� I
rNa2 , J Else IX�IrCf� QbCt
Company: '�1m> rn
Address: �i x'� � �'—= fin Address: i ta8 7flMat�A 'D/
City. 4 P -e`�C2 Stated
I ,11 KLtlFja / Ve�G,1 State: �1 i
2 city: I.d«
Zip Code- Fax_ Fax: 3Z1- 777- LILL4 _
I Phone
�<RI So
�-I i Zip Code: 3Z93�
Phone No. 772 337- 70
I;I E-Mail - _
Fill in fee simple Title Holder on next page
�f different E.-Mail: ( �re��huunna�
from the Owner listed above) ' State or County License:
I
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
-
..
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: M~ _Not Applicable 4
I Name: �, Name:
Address: Address:
fCity: State: City: State:
Zip: Phone: Zip: Phone:
I
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
I
city: _ 1 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 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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of ncement.fi
i
FEI��::
5
Signature of Owner/Lessee/Agent Signature of Contractor/License Holder I_ i
STATE OF FLORIDA -�,1 STATE OF FLORIDA
COUNTY OF T)I ��IC�1 U COUNTY OF_r C a-d
The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this 20 Aaby i this da 20 FL by
i
i Lu-I�S uS
( ers a 9 1"n,0 ) i ( r o c le )
( i u o c to of Florida) a ate of Florida )
Pers R Produced Identification Per N OR Produced Identification
Type ofFd duced j Type o n
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BRO SZIG�^7 7
Commission No. Commission No YCOMMIS C 24 46r�
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m � EXPRES;Ju ne25,2019 h YPub CUndeneslRXPIRES' 9
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