HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and DeveioomenrServices
Building and Code Reguiazion Division
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2300 Virginia Avenue, For,Pierce 34982 ,J
Residential
Phone: (772)462-1553 Fax: (772) 452-1578 Commercial
PERMIT APPLICATION FOR:
Address:_II kI�fVTI/Q�W� ��
Legal Description: .A�cu) ->�CY�ltj V LtrF2I� �14�� 2G��`"�_2
Property Tax ID#: �Dff)-Sol` COPY31 (OO- LA Lot No.24
2
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right JiEle:
Left Side:
Joon
Additional work to be pertormed under this permit-check all that appy:
Mechanical _Gas Tank _Gas Piping _Shutters ✓Windows/Doors
_Electric _ Plumbing —Sprinklers _ Generator _ 'too
Total Sq. Ft of Construction: _ Sq. Ft. of First Fioor:
Cost of Construction: $ `�i • Utilities: —Sewer _Septic Building Height:
Name
8n9iAn r y
I (Dame vn� www
5 1 -
�-Iam-- C
Address: 1
Company: ( IYI car ✓.n'ise ZXrucs LG r�v� �
City: Fpr+-L)1r-1'Ctf, State: FL address: 1105 to
Zip Code: ���t��j, Fax:wl��/� City: lnd<ana�� Qeoc�` State: t i
�JI1 �kf /
��'f pax: 3�1- 777 �{Z3y
Phone No. lip Code: SZq
"t-Mail: A1l4 Phone No. 772 337-gg70
ii Fill in fee simple Titie Holder on next page ( if different -Mail es5ha�nna(-Z
from the Owner listed above} State or Count iccnse: C �(
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
DESt6NER/ENGINEER: _ Not Applicable I MORTGAGE COMPANY: � _ Not Applicable
Name: , ;Name:
' Address: f Address: �
City: State: City: State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address: j
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 Home Owners Association and review your deed for any restrictions which may apply.
in consideration of the granting of this requested permit, 1 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
comm cin work orrecoroirrVour Notice of Commencement_
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_Signature of Owner/Lessee/Agee: 5 gnature of Contractor/License Holder
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STATE OF FIL A STATE OF FLOBJDA J
COUNTY OF_- G.Yd COUNTY OF yard
The forgoi , menL -cknowledged before me ! The for oing instrum-nt was acknowledged before me
this v 20 _b this 20 by
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Ai r a re of Florida) ta of Florida 1
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1`5 y n R Produced Identification P_ K roduced identification
T o 'd P used Typ o d +,
Ate$ ; .^'.'4 ,��Rp0 �KESZIGETIION#FF244655 .
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j Commiss B ZIGETI Commissio _'�a•'
MYOOMMISSI0N#FF244655
`o ,, EXPIRES:June 25,2099 r
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EXPIRES: otaryPadicUndswiter.,
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Revised 07/1.5/20
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REVIEWS FRONT ZONING SUPERVISOR I PLANS VEGETA T ION SEA TURTLE MANGROVE I
COUNTER I REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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