HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN ERJENGINEER:
� Not Applicable MORTGAGE COMPANY:
Name:
Name:
Address:
Address:
City:
State: City:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable BONDING COMPANY:
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.
Not Applicable
State:
Not Applicable
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 recordin your Notice of Commencement.
s
Signature of Owner/Lessee/C tractor as Agent for Owner Signature of Contrac r License Holder
STATE OF FLORIDASTATE OF FLORIDA C
OUNTY OF CCOUNTY OF tUv
The for oing instru en was acknowledged efore me
this day of —3" 20 Mby
(Name of person a cfiowl ging )
Signature N ry PubhS; ate of Florida)
Per__(jii .l(_ .r- Q Produced Identification
Typ ifiel�ti�lnr�•.,•u1Gc
MY COMMISSION # FF2336
Corti-o.__ExP'Rr=SMa 21 :.all
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y5crvice.con:
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
The fooing instru ent Incas acknowledged before me
I
this day of I -t 20 0 by
(Name o e'r n ackno " gi g)
ignature of`P,6fary Public- St e of Florida 1
Persona lin _ ' OR Produced Identification
Type of c[iotlr�l;
+: MY COMMISSION # FF23f§k
Commis
PI RES May 21, 20 19
�d0f&3&i;-L''53
F kin Aa N o:a ry S e r v+ce. co m
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
- J,.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34.952
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: sgll 1?? I ! 9 1F1 C) '1 �214
Legal Description: POD 3Z N W &napvg
Property Tax ID —600, ` 0007 _ 000'
Site Plan Name:
Project Name:
Setbacks Front Mack: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to be pertormed Under this permit— check all that apply:
0HVAC DGasTank Gas Piping FIShutters 0 Windows/Doors
11 Electric ® Plumbing U Sprinklers FIGenerator 0 hoof I I Roof pitch
Total Sq. Ft of Construction -Sq. Ft. of First Floor:
Cost of Construction: $ /1
00 Utilities: Sewer [LloitSeptic Building Height:
OWNER/LESSEE: t
Name vt%a up,,�1 Sc Y"I+'��-p
Address: ff� t'
El XA" l ovl Rd
City: 9.S L State: FL
Zip Code: 9fo Fax:
Phone No_
E -Mail:
Fill in fee simple Title Bolder on next page (if different
from the Owner listed above)
CONTRACTOR:
I
Name: _ SfQVn u0i `
Company: i�'; 77 ,, 1!!"l To C -
Address: aq y A -1/e
City: Tb Ue St te: FL._.
Zip Code: 2)r q l=ax:- �
Phone No. c7�` i lia1 Q)
E -Mail: <4
State or County License: C) 2
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.