HomeMy WebLinkAboutpermit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date: //D -A
Miming rerrnix HppiiCaVon
Planning and Development Services
Building and Code Regulation Division
23oo Virginia Avenue, Fort Pierce FL 34982 Cprrlrrtercial �_ Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PEKMI I APPLICA I ION I -OK: To Select frorn dropbox, click arrow at the end of line
pROPOSEU IMPROV_E_MENN I L_UC:_AI ION:
Address:---------._.._- �'%�,y ✓ ��i'1l(%�
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Back: _— Right Side: Left Side:
Setbacks Front__
iii--v'R1PIION OF WOKK:
-OA
CONSTRUCTION INFORMATION:
►tions wor to 6e er ormed un er tFiis —perm if= cf
0HVAC Gas Tank ❑Gas Piping
Electric El Plumbing Sprinklers
Sq. Ft. of First Floor: _
Utilities: 0 Sewer 0 Septic
Total Sq. Ft of Construction: !/ _
Cost of Construction: $
Lot No.__
Block No.
that apply:
_Shutters aWlndows/Doors
Gene rztor
Roof Roof Pitch
OWNER/LESSEE:
Name �t �
Address: 1a t,
J-1
rm State: M
City:
Zip Code: dot (� 5 r� Fax:
Phone No.
E -Mail: -,-
Fill in fee simple Title Holder on next page ( if different
1' ted above)
CONTRACTOR:
Building Height:
Name:
� i' i l A 4 l -tib c n
d �To rpt t e6't'
Company:
I : 15 S /,I r- ee i-,
Address,:
t G Rt SL L o c i J State: rL
City:
Zip Code:
+q 51 Fax:
Phone No.
T1 a, 3 3:5' - 3 3
E -Mail:
CN '�tE�IC Sties C'o CGYiL
CA
State or County
License:
from the Owner
tf value of construction is $2500 or more, a RECORDED Notice of Commenc�nent is require .
I certify that no work or installation has commenced prior to the issuance of a it vrill autho izeethe ermit holder to build the subject structure
St Lucie County makes no representation that is granting a permit
which is in con ict with any, applicable Horne tiers er Association Association
le, bylaws r deed for any estrictiothatns which may apply bit such
structure. Please consult with your N
In consideration of the granting this
the Floe da Building Codes and St Lucie rmit, I do hereby agree Counld pe ty Amendmentsperform the work
in accordance with the approvedp review: room additions,
The following building permit applications are exempt from undergoing a full concurrency
in twice for
accessory structures, swimming pools, fences, wails, signs, screen rooms e cement may result in your payory uses to another ing
use e
WARNING TO OWNER: Your failure to Record a Notice of Cam consult with lender or an attorney before
improvements to your property. A Notice of Commence financing, t must be recorded and posted a the Iobsl
before the first inspection. If you intend Notice o Commencement.
commencin work orrec dingy
- License Holder
Owner
Signature of Contra or/
License
Signature of owner/ essee/Contractor as Agent or ORIDA
STATE OF FLORIDA, . U /
COUNTY OF
The forgoing instrument was acknowledged before me
this day of _!' 71—
20 /'Ib.
Lt r^ 1<I C lit IYlC?Y1 S
(Name of person acknaW{edging )
(Signature of Notary Public- State of FI a )
IPersonally Known ✓/ OR Produced Identification
Type of Identification Produced
Commission No. ltt 0 5�
Revised 07/15i2014
REVIEWS FRONT ZONING
I COUNTER REVIEW
COMPLETE
INITIALS
CHRtS M B
STATE OF FL
COUNTY OF O" LyC / F
The forgoing instrument was acknowledged before me
this day of --- Za _by
M& n S —
(Name of person acknowledging)
(Signature of Notary Public- Stat of Flori
Personally Known t/ OR Produced Identification
Type of Identification Produced
.01Pr ry CNk';
mission No. * tAW�
j;j-..n tBcIJp 1jdwy5vArye
SUPERVISOR` PLANS
REVIEW I REVIEW
MYcOMmWON! GG O48
p t MRES:Apr14,2021
VEGETATION I SEA TURTLE MANGROV
REViE41. REVIEW E
REVIEW
M-.
ION LIEN LAW I Nt-ORMA i ION:
SUPPLEM EN I AL CONS I RUL
I
Not Applicable
Not Applicable MORTGAGE COMPANY:
DESIGNER/ENGINEER:
_
Name:
Name:
Ad dress: State:
Address:
State. City:
Phone:
City:
zip:--.
Zip: Phone:
i Applicable
Not App
FEE SIMPLE TITLE HOLDER:
Not Applicable BONDING COMPANY:
_ Name:
Name:
Address:
Address:
City:
Phone:
City:
phone:
Zip: ___
Zip:
I certify that no work or installation has commenced prior to the issuance of a it vrill autho izeethe ermit holder to build the subject structure
St Lucie County makes no representation that is granting a permit
which is in con ict with any, applicable Horne tiers er Association Association
le, bylaws r deed for any estrictiothatns which may apply bit such
structure. Please consult with your N
In consideration of the granting this
the Floe da Building Codes and St Lucie rmit, I do hereby agree Counld pe ty Amendmentsperform the work
in accordance with the approvedp review: room additions,
The following building permit applications are exempt from undergoing a full concurrency
in twice for
accessory structures, swimming pools, fences, wails, signs, screen rooms e cement may result in your payory uses to another ing
use e
WARNING TO OWNER: Your failure to Record a Notice of Cam consult with lender or an attorney before
improvements to your property. A Notice of Commence financing, t must be recorded and posted a the Iobsl
before the first inspection. If you intend Notice o Commencement.
commencin work orrec dingy
- License Holder
Owner
Signature of Contra or/
License
Signature of owner/ essee/Contractor as Agent or ORIDA
STATE OF FLORIDA, . U /
COUNTY OF
The forgoing instrument was acknowledged before me
this day of _!' 71—
20 /'Ib.
Lt r^ 1<I C lit IYlC?Y1 S
(Name of person acknaW{edging )
(Signature of Notary Public- State of FI a )
IPersonally Known ✓/ OR Produced Identification
Type of Identification Produced
Commission No. ltt 0 5�
Revised 07/15i2014
REVIEWS FRONT ZONING
I COUNTER REVIEW
COMPLETE
INITIALS
CHRtS M B
STATE OF FL
COUNTY OF O" LyC / F
The forgoing instrument was acknowledged before me
this day of --- Za _by
M& n S —
(Name of person acknowledging)
(Signature of Notary Public- Stat of Flori
Personally Known t/ OR Produced Identification
Type of Identification Produced
.01Pr ry CNk';
mission No. * tAW�
j;j-..n tBcIJp 1jdwy5vArye
SUPERVISOR` PLANS
REVIEW I REVIEW
MYcOMmWON! GG O48
p t MRES:Apr14,2021
VEGETATION I SEA TURTLE MANGROV
REViE41. REVIEW E
REVIEW
M-.