HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED,FAPPLIC�ATIC+N To BE.ACCEPTEL?
Date: Permit Number: U
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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 Commercial Residential.-
PERMIT
esidential -PERMIT APPLICATION FOR: To Select fromdr'opbox, click arrow at the end of lirie.
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Address: 1 `�
Legal Description: (V+- K `4-1 Lp+ l$
Property Tax I[)#: lq moo- 015a- OUO- Lot No. 5
Site Plan Name: reel BLK-P_.C'(Y1a_n Block Nolf L4_7
Project Name- 2
Setbacks Front Back: _Right Side: K4 Left.Side: l�
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Additional workto be performed un ert is permit-c ec 3,e�that appy:
HVAC Gas Tank aGas Piping Shutters WiridowsJDoors
Electric PlumbingSprinklers 0 Generator ,Roof '_Roof:pitch-
Total S+q.'Ft of Construction: SQ.Ft,of First Floor:
Cost ofConstructioris$..= ti ,o a`"}o� 00 Utilites SewerL�iSeptic ,,..Building:Height: -
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Nare_. : C h_. Gfe L Name PeterAafailt s ,>
Address: it ���er- enQ-pct C+. Lowes 1-lonte Lente tLC:
Company: �F
City,: Porgy' ar(�=�-'LUL{ State: L Address.
P.f3.W%61993" x, ,
State: FL
Phone No. D5(Q(- 77a 1- 15(.01( Zip Code: 32878-1993 Fax:
E-Mail:fili+rh Q�"mi"�q►ZV�P- (, [C 21 Phone No. SLI I-
Fill in fee simple Title Holder on next page{'rf different E-Mail I►'�i�1 G12 P �m�: (ar0 uL• !Yl
from the Owner listed above) _ State or County License:.,WC1 50;3417
Ifvalue of construction is$2500 or'more,a RECORDEMNotice of:Commencement is required.
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DESIGN ERJENGINEER: _Not Applicable MORTGAGE COMPANY: —NotApplicable ;
Name: Name:
Address: Address: '
City: State: City: Stafie
Zip: Phone: Zip: 'Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: 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 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 51.Lucie County Amendments.
i 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}efor
improvements to yourFco�rd
ert .A Notice of Commencement be recorded and posted on the jcibsite
before the first i ectlfyou intend,to obtain financing,-consult With len o an attorney.before
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commencin . rk r rin ur Notice of.Commencement. .
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Signature of O n r/Lessee/Contractor a A en for Owner Signatur of Contractor/License H Ide
STATE OF l OR DA STAT FLORIDA
I
COUNTY o COUN OFA +
The forgoing'nstru ent,vras acknowledged before me The fagoin instrument was.acknawledged before me;..
this�day f 20 J&by this,T d .of` Tuft,E 20 L&,1 y
Petr a cafaro[U a Peter cafaro til
(Name of personacknowledging) (Name of e acknowledging)
Signature of N"tary Pu it-State of F orida) (S gnature o N tory Pub is-State ofaloria '
Personally Kn��. n x OR Produced Identification Personally Known x OR Produced Identification
Type of Iden ification Pr Type of Identification Produce
o Rotary P+ibric State of Florida
Commission No. x°` Kari M1¢� bohi Comr[rission Np. *wdr-
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Notary tate of Ftodda .
i. Ka CommI 1011 FF 98164'7 Karl Ad t ani
�a 51?81202t} Y Carnmissian FF 961647Ezpirss"OSt28t2{a2D `
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION:.:, -SEATL)RTLE, .MANGROVE!,
COUNTER REVIEW REVIEW REVIEW REVIEW F REVIEW REVIEW
DATE ,..
COMPLETE
INITIALS