HomeMy WebLinkAboutBuilding Permit Application Nov 071712:20p P.1
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j ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 CommercialResidential!
PERMIT APPLICATION
FOR: To Select from dropbox, click arrow at the end of line
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Address:J`J 1 )' a,5 iii tt {� 1�Tbr4 ji.)Ci
I Legal Description:QRtmi4 Ve5TA(,go5SiWC� ReMPLr}T No.3Lfa La-,7) TRffCT bi 648jc)6G►P,
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PropertyTax ID#: 3(4'L2- ` %5%~ owl "ow - � Lot No.
Site Plan Name: Block No.
Project Name: c-p-C& -
Setbacks Front Bark: Right Side: Left Sider
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i1 �tiona wor o e er arme un er t is permit-c ec a appy:
LJ�' '— HVAC Gas lank Gas Piping _Shutters UilirtdovasjL?oors
l_JElettric Plumbing �Sptinklers
Generator Roof'iRoofpitch
Total Sq.Ft of Construction: SQ. Ft,of First Floor:
Cost of Construction:$ 11 R 3. G Utilities:Sewer Septic Building Height:
`27� .i1 , : .y'$•J p+��4rOffl9�[.1!'.r-.1.x"3•—`er
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Name l '�RiMA 1f ISTfi CRpSSi nC\ LLC. Name: 41 t n
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Caman .v E ' d
Address:"15'-11 �JVf1S2t D t'. �,
City: Lxct..P G0,61-es State:�G Address: r? rh rk't""ad-A.t LP �, i~t li
! Zip Code: 3*3 3 Fax: City: Ptr�-- 64-r,Lttcla,, State:
Phone No. b ��3��ji,(o Zip Code:� � n ; Fax: ?7a -�3�t- �I
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E-Mail: Phone No. 7-7 - X71 t_"Gp
Fill in fee simple Title Holder on next page{if different E-Mail: ]9,66 t2`/!f+-C- Seri
from the Owner listed above) State or County License, . �{?l
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required,
Nov 071712:20p p.2
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DESIGNERANGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: I State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE, HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Nage: 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.
St.Lucie County makes no representation that is granting a permit wilt authorize the permit holder to build the subject structure
which is in conflict with any applicable dome 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.
to consideration of the granting of this requested permit,I do hereby agree that I will,in ail 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 pasted on the jobsite
before the first inspection.if you intend to obtain financing, consult with lender or an attorney before
commencin r recordi ur Notice of Commencement
i Signature of owner/Lessee/Agent Signature ofTtontractor/License Holder '
couru°to FLORIDA `r`tC' ~, �.t,�C' t COUNTY OSTATE OF F s4. ,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of �- M)Q)QA , 20 aby this n day of 01�4 eim62f,20 by
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(name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) �41g ture of Notary Public-State of Florida J
Personally Known OR Produced Identification Personally Known OR Produced tdentlfication
Type of Identification Produced Type of Identification Produced
Commission No. S Y S•.LiN ARiE BOUCHAR commission No. *"'°` y`,D `' *�/ru�D
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