HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��'�� Permit Number:
.. J
outiaing Yerm,T HppiicaTion
Planning and Development Services
Building and Code Regulation Division
2300 Vrginio Avenue, Fort Pierce FL 349182
Phone: (772) 462-1553 Fax: (772) 462-1.578 Commercial Residential
PEKMI I APPUC;A I ION I -UK: To Select from dropbox, click arrow at the end of line
PROPOSED IMPKOVEMEN 1 LUG4I ION:
Address:
Legal Description:
Property Tax ID ##: J Zld q - fee- C/2e -ra Lot No.
Block No.
Site Plan Name:
Project Name:
Setbacks Front Back;
UE I AILED UESUIP I ION Ut- WQKK:
Right Side: Left Side :
z 1 /4 f--, t // Tom
u,,,> /0 ,'Gv xav�
CONSTRUMON INFO RMATIOM .
ona wo oBe rm un er is permit - c ec a =:ut�be
HVAC Gas Tank Gas Piping rs Q Windows�Doors
11 Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 7 � %S O�
Sq. Ft. of First Floor. _
Utilities: 0 Sewer 11Septic
OWNERAESSEE:
Name 1�ruck c �R�ITE ,gym r2
Address: Dill
City: 1, /t 1 -,,, / e State:
Zip Code: A��5,2 Fax:
Phone No. 7 7d J
E -Mail:
Fill in fee simpte Title Holder on next page ( if different
from the owner listed above)
Building Height
Roof pitch
CONTRACTOR:
Name: C U VET l s LA ru kyr c n S
Company: l �l sTo n1 r �y stem'
Address: V l 11 14r f n p
Po RT St . L uci t-- State:1-t—
Tup Code: 3-4-q 52- Fax: 77.?- J
Phone No. '1 1 ZL 336 -3132-
E -Mail:
3S -3232-
E -Mail: C L. S t Ct I r S 't s a o l _c c, vr,-
State or County License: G O 5 (8
If value of construction is $2500 or more, a RECORDED Notice of Comnlenceenit is reqs-
SUPPLEMEN I ALCUNS I RUC I [ON LIEN LAW INFURMAIION:
DESIGNER/ENGINEER: Not Applicable
IMORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
i Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable i
Name:
Name:
Address:
Address: :
City:
City:
Zip: Phone:
Z-1 P: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St- Lucie Countymakes no representation that is granting a permit will authorize the permit holder to build the subject structure
wh,ch is in conflict with any applicable Home Owners Association rules, bylaLvs or and covenants that may restrict or prohibit such
structure. Please consult with your Horne 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 grill, in all respects, perform the work
in accordance vrith the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The folio Ang building permit applications are exem.ptfrorn undergoing a full concurrency review: room additions,
accessory structures, sLvimming pools, fences, uvalls, signs, screen rooms and accessonr 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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of OLl-ner/Cessee,`Contracior as Agent for O,vner I
Signature of Contractor/License Halder
STATE OF FLORIDA !
STATE OF FLORIDA
�•
COUNTY OF L� 'i• C% C` i
I
COUNTY OF t%Gi <'-
The forgoing instrumert was acknowledged before me I
The forgoing instrument was acknowledged before me
this ;' day of J c ! 20 /J by I
' I
this /oZ day of J-V4Y 20 by
' CU 1- �' 14111 IYIOYI
(Name of person acknowledging) ((Name
of person acknowlzdging )
a-Z
(Signature of Notary Public- State of Figl a j
(Signature of Notary Public- Stat of Flori '
r
! .
Personally Known OR Produced identification
Personally Knowvn OR Produced Identification
Type of Identification Produced_
Type of Identification Produced
i Yv CHRISTINEBEtIt%ftmission
Commission No- (3-t G7 e ✓,� �l�-
No. `l t7
rgBa4
MY COMMISSION rt
Wd
� t
,
GG 052546 P t l
M1 P
9�0/}6 � Banded TtvuBudget NotMSermas
2EXPIRES: 09Y
D •• - o -COMMI SI N#GO0 2
* COMMISSION� GG 032548
Re--ised G /1Si2614
*MY
FV
�oma EXPIRES: APM 4,2021
REVIEWS FRONT ZONING P SUPERVISOR I
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW '
REVIEW REVIEW REVIE'A' REVIcW
DATE i
COMPLETE - - -
INITIALS