HomeMy WebLinkAboutBuilding Permit Application'I, "3 )cu P/49 Cut - 'V& /
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Roof
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (72) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: c\ 9(1JL4J(tj f
Legal Description: (3)do D., I - 6Ad
Property Tax ID U:
Site Plan Name: \
Project Name: c v'V'tjr\
Setbacks Front Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WOR
Lot No.
Block No.
/J8drci&
CONSTRUCTION INFORMATION
Ad,gIt*nal work to be erformed 'linder this permit - check all that apply:
AC \ Ga Tank \ \ [la' Pipipg I Shutters
Electric
El Plumbing Sprinklers [Ii Generator
Total Sq.ft of Snstruction: -
Cost ofucon:$ Se er7
OWNER/t.ESSEE: CONTRACTOR:
Name .f Name: . c
Address: Company:
City: I Q State: Address:
Zip Code: 3 'tt t'-t.j Fax: City: 6kh/J42f7A92 State:
Zip Code: Fax: Phone No.
E-Mail: . Phone No.
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: J rt' S'/) brq 9' f::14c:t /4i 'ñj
State or County License: (Y-4O5 'S'/
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
S . Ft First Floor:
Utilities: . eti Building Height:
/
Signature of • ner Lesee/ContractoraAgent forOwner
STATE OF FLO
COUNTY OF
Signat e ' pntractor/License Holder
STAT[OFFLORI
COUNT( OF
Commission No.
f-kte,2 /
(Nam f erson acknowledgin
my—
(Name o per n acknowledgi
(Si: ature • ota
/ I /
L
ignaure of OTrlpu. S ate of Florida ic-Stat- of Florida
Personally Known
Type of Identific
OR
on
Revised07/15/20 14
Commission No.
SUPPLEMENJTAL CONSTRUCTION ',L]'ENI LAW INFORMATION
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:
Name:
- Not Applicable
Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable BONDING COMPANY:
Name:
Not Applicable -
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 Countj makes no representation that is ranting.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.
consideratid df the granting othi reuested perhiit, 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 afull concurrenc review: room additions,
accessory structures,'swimming po.ls, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Yo /failure to Record a Notice of Commencement may kesult in your paying twice for
41 improvements to your p 9 s erty. A Notice of Commencement must be reçor. -d and. posted on the jobsite
before the first in sec. . If you intend to obtain financing, consul I-' der or an attorney before
commencing gj.r cording your Notice of Commencement.
The forgoing instrument vias acknowledged Vore me
this day of '3-L4,1 20 ) bby
The forgoing instrument yeas acknowledgedbge me
ihis ) a-day of 31..L , 20 / y
REVIEWS 'FRONT
QUN''ER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW,
SEA TURTLE
REVIEW
MANGROVE
REVIEW DATE
COMPLET'E
INITIALS