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HomeMy WebLinkAboutKlinkALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: L Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34952 Phone: {772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click here��+�,, PROPOSED IMPROVEMENT LOCATION:' Address: 2::K Legal Description: Property Tax ID #: 0 ca 3S"7 `'-% D(r� D a UO �L%Cvci 3 Lot Not Site Plan Name: Block No. Project Name: Kr rt, Setbacks Front Back-. Right Side: Left Side-, DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION Additional work tonG�T orme un ert is Perm it -c ec a appy: HVAC k Gas Piping 0 Shutters 11 Electric _ Plumbing Sprinklers OiGenerator Total Sq. Ft of Construction: Sq. Ft. of First Floor: _ Cost of Construction: $ o DD Utilities: Sewer ElSeptic OWNER/LESSEE: CONTRACTOR: Name ` ke 1, C\ Name: Address: V-) 1--, i�, c._ c- -�`c - _ tom n City: State; _ s' r Zip Code:`( -t Fax: City. Phone No:Z--) ZS9-- 1-2Z� ;� Zip Code: E -Mail: Phone N9. � Fill in fee simple Title Holder on next Page ( if different E -Mail: �R from the Owner listed above) State or County Licensez If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. Windows/Doors Roof Building Height: —� State: - ���r. ��i ~i ��iza •:T, b°' ���t���'.����� {L a� f f ,°,.$:`8i'7r.� .;�����"`5-.�m'� ...J I' .4ht DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: 'm ..ot-iAlIyL_ Name: REVIEW Address: REVIEW Address: (Name ofd rson acknowledging) City: State: City: State: Zip: Phone: (91griiture of N tart' Public- State of Florida) Zip: Picone: COMPLETE FEE SIMPLE TITLEHOLDER: _ Nat Applicable BONDING COMPANY: _ Not Applicable Name: Name: INITIALS Address: Address: City: City: Zip: Phone: Zip: phone: 1 certify that no work or installation has commenced prior to the issuance of a permit. 5t. Lucie County makes no representation that Is granting a permit will authorize thepermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or an 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 thls requested permit, I do hereby agree that 1 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 your property. A Notice of Commencement must be recorded and posted on the jobsite before first ins ection. If you intend to obtain financing, Gansu Iib -lees -erten attorney before comiencl r or recur i ur Notice of C©mmencem _ Signature of Owner/ Lessee/Agent r� Q� STATE OF FLO SUPERVISOR COUNTY OF VEGETATION S The forgoing instrument was acknowledged before n s� this day of 20 by The forgoing instrument was acknowledged before m �—n1 !A C!l 'm ..ot-iAlIyL_ (Namepf person acknowledging) of Notary Public- State Personally Known OR Produced identification Type of Identification Produced Commission No. EE qV � I (Seal) Revised 07/15/2014 Signature of Contrrctor/License Holder -- STATE OF FLO r� Q� COUNTY OF SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE The forgoing instrument was acknowledged before m COUNTER this day of .-- 20 by z REVIEW REVIEW REVIEW REVIEW (Name ofd rson acknowledging) i111i�b$ry`��,. % e�z (91griiture of N tart' Public- State of Florida) !AA*A►�,`�'�`� COMPLETE Personally known L-- OR Produced Identification Type of Identification Produced Commission No, �1�`7 J� �� (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS