HomeMy WebLinkAboutbuilding permitBuilding 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 Residential V__"'
PERMIT APPLICATION FOR: A II L
- b KL �Ct Kc
Address: tQ`)D,_tS I (01_ty) '�/ t1Q, ' jLt,
Legal Description: 0 1 S' Pf- ' ��—
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No,
Block No.
;!Mechanical — Gas Tank _ Gas Piping —Shutters , Windows/Doors
Electric , Plumbing i Sprinklers Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor. _
Cost of Construction: $ Utilities: —Sewer —Septic
Name IrN f -'-�
Address: �a; JGLUYIr �
City:t State: F
Zip Code: -2 `A Ci Fax.
Phone No. -7-7
E -Mail: -- -
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Roof
Building Height:
Name: J C
Company: ``011.rr',`i i
Address: Z51
City: Stater
Zip Code: U3 `i q Sq Fax:
Phone No -7'7,,3 - IQF - `7 7
E -Mail 6fulcl S i h CAD I• C 6
State or County Licenl_jiilinse /� (rj%GJ
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 you property. A Notice of Commencement must be recorded and posted on the jobsite
before the first ins cti . If you intend to obtain financing, consult with lender or an attorney before
commencingw o cordin our Notice of Commencement.
ner/ Lessee/Agent
$WE OF FLORiip
COUNTY OF L`i fL
. SU
The f r oing instru en was acknowledged before me
this day of _ �(J -,0.�- 20]J by
l
(Name of person acknowledgin )
IE
(Signature of Not Pub le- S e of Flom
SABRIN � A �� rhtissrohfi.�',
Personally Known�o �gsuarY22�Na`
OR Prod uccS j<d�ration �
Type of Identification
Produced #FF195337
Commission No. 45%�9 •'• 04 4
ST
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Wntractor/License Holder
2F FLORIDA
LINTY OF J ,
The forgoing instrument was acknowledged before me
this , day of 20-0by
(Name of person acknowledging~-)
(Signature of Notary Public- State of FIZAda�•��Mlhlgslpy,
SABRINA L. BLACK �
`� �e�5��y�
PersonallyKnown ✓ OR Prod ucic 1Clen41cationa %
Type of Identification =� ~•s`
Produced:t�OPP19,6. *
r o' �A°ededlhM . i
Commission No�-F!r 5,3 ;j 7 11. E. p' � <�
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