HomeMy WebLinkAboutBuilding PlansALL APPLICABLE INFP M% ]
ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
I r 2
Date: lol/ 1 e Permit Number:
3 -
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone. (772) 462-1553 Fax. (772) 462-1578 Commercial Resi,'dential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Description:
in
FA
Property Tax ID#:�Ll - �Vo�—� /-�l`�- [�(��(�^� Lot No. f
Site Plan Name: Block No.
Project Name: (i
Setbacks Front Back:
1]HVAC
11 Electric
0 Plumbing
Right Side:
Sprinklers
Left Side
"Shutters
EGenerator
ows/Doors
Total Sq. Ft of Construction: S. Ft. of First Floor:
Cost of Construction: $ (0-(0�e UtilitiestSewer Septic Building Height:
I
Nam ! /a n f-tUt%ll
Address: c;20)
City: PSI Stat
Zip Code: 31&s-?-_ Fax:
Phone No. c9 5,'Q
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
car pany: uol i r n i nv v -i /
Address:% r� s NJ f I
U 1,
City: Stat
Zip Code: 3 y6i SZ ` Fax: 3 3 �'/
Phone No.
E -Mail: 11
State or County License: Cr c /-p
IIf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: _
Address:
City:
Zip:.
Phone:
MORTGAGE COMPANY:! _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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
vMmencing,work or r co ine your Notice of Commencement. --i, ! / /
C141—
re of Owner/Lessee/Contractor as(Ahent
STATE OF FLORID
COUNTY OF
The fofping instrument was acknowledged before me
thisLf'rVV lday of/20 l�by
�� I �r6zfaz)�2a n
(Name of person acknowledging
(Signa ure of Notary Public- State of Florida )
Personally Known V' OR Pro9(moiiff
Identification
Type of Identification Produced
a e o lvisCommission No. "1 sionFF969/2020
Revised 07/15/2014
re of Contractor/L'
STATE OF FLORIDA
COUNTY OF ��'-f - . (VA Come,
The forgoing instrument waas�ack�nowledged before me
this Liray of &, f/ ► i(/1�, 20 is by
® n
(Name of person acknowledge i g
C /1 Vr I 4�'1b�j
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
°cad Identification Produced
li"
o,ee-
vsn pt, l%iotarj Public State of Florida
? & 'r bennifer Davis
y ommi�
Expires 0212912020
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