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Home My WebLink AboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: J -d/_ / i Permit Number: ouiming rermn jAppilicativn Planning and Development Services Building and Code Regulation Division 2,300 Virginia Avenue, Fort Pierce Ft 34982 Residential Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PEKM1 I APPLICA I ION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMNKOVEMEN I LOCAI ION: ---- Address: �o la M b ri�c Cir Legal Description: Property Tax ID #: �Y�- ®d'/9.17e7© Lot No. Block No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: UEIAILED UESCKIPIION Of- WOKK: L ll ; e l=''r LIKe 31,0" /oree C-k'V^sc- 0 ar- CONSTRUCTION INFORMATION: HVAC Li Gas Tank uGas Piping Electric 1i Plumbing ❑Sprinklers Total Sc. Ft of Construction: Cost of Construction: S 7 yll s OWNER/LESSEE: / ®/rim LJ_ Shutters ❑, Windows/Doors E] Generator F]Roof Roof !itch Sq. Ft. of First Floor: _ Utilities: 0 Sewer a Septic Name Address: S t City:/Y�i1i * yrJ State: Zip Code: Phone No. E -Mail: FII in fee simple Title Holder on next page ( if different from the owner listed above) CONTRACTOR: Building Height: Name: SArLl6AC 0S Company: C t t 5 -To n1 Address: 1 lt�I $yt t dG r ee t1 City: Pct i2T .S% , i,.. u C i - State: r� Zip Code: 61+4571- Fax: Phone No. -I'll 33 S - 313 � E -Mail: Cu StC'ttr Stis Qo�•C[w� State or County License: C°, C o S ( 9 � I, tf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEM EN I AL CONS I RUL 1 ION LIEN LAW I NFORMA I ION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: ! i FEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: i City: City: Zip: Phone: i i Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Countv 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 vAth the approved plans, the Florida Building Codes and St. Lucie County Amendments. The folloaping 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 WARN ING 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 commencing work or recording your Notice of Commencement. e t ' s I s Signature of Owner/ essee/Contractor as Agent for O:;mer Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 't iL i % C' f r_: COUNTY OFt The for oing instrume :t w cknowledged efore me The forgoing instrument moa acknowledged b ore me p this r` day of 20 �by this � day of 20 by z. Yyl Oflo YA S (Name of person acknowledging) (Name of person acknowledging) 1 (Signature of Notary Public- State FbV& (Signature Notary of J of Public- Stat of FIork.10 Personalty Known vfOR Produced Identification Personally Known 'r OR Produced Identification I 1 Type of identification Produced _ Type of identification Produced J r/ j j o� GHRF?it.�' ; � � CHRISTINE B t71 t'j � � � � `1 i.� AV Commission No_ � mission No. tTt a 0 �ift r � '7 Y: a:. • c I r * * �;v -: . ,•,, : * * MYCOMMISSIM GOSH : • y Pf Or _ N EXPIRES_AprP .2021e • ;.: 9 ,� �t Bw&dllw smokes ODM, BudgetNeWy � . Revised 0-17/15i(2014 * * MYCOMMISSIONm06'm a� `oma E*1RES:AW 4, 2M1 i i REVIEWS FRONT ZONING SUPERVISOR { PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW l REVIEW REVIEW REVIEW DATE COMPLETE INITIALS kk