HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO B ACCEPTED Nou
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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 APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: aa[aYAvAAj DR,
Legal Description: - t�ni t T - `•� t �p
Property Tax ID#: Lot No.
Site Plan Name: --r- N c, Block No.
Project Name: 'r V iP(moi C1 a V G-A A , r
Setbacks Front Back: Right Side: eft Side:
"p..o ra-r I";N-r Co re N e e, o-F' H o.u e 0 0 T 3, r W`iTk-
a►o.v b f 'p, ►
lonawor to e e rme un er t is permit-check a apply:HVAC Gas Tank []Gas Piping _Shi itters Windows/Doors
Electric Plumbing []Sprinklers Q Ge ierator Roof Roof pltch
Total Sq.Ft of Construction: So.Ft.of Fi t Floor:
Cost of Construction:$ Utilities:0Sew r 0 Septic. Building Height:
111 Fill
Name ..,.l -ry Narr)e.. __L t>A Pa te L -I—J KN e
Address: ( 2Q ) R til S2 A AL Q P1, _ Co r pany;�
city: c5rz-,- S` (Al C e State: L Address:
zip Code:_34019�-_ Fax: City: State:47G'
Phone No. ` O y, , 3 q Z p2-7 Zip Code: Fax:
E-Mail: Phone No. , OB44 -
Fill in fee simple Title Holder on next page(if different E-Mail: CQ K
from the Owner listed above) State or C7unty License:
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
7DESIGNER/ENGINEER: Not Applicable MOR'1GAGE COMPANY: Not Applicable
Name
Address: Address:
City: _State: City,. I State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: T Not Applicable BONDING COMPANY: —Not Applicable
Name: Name:
Address: AddresF�:
City: City;
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance o a permit.
St.Lucie County makes no representation that is granting a permit will authtrize 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 agreehat I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Li cie County Amendments.
The following building permit applications are exempt from undergoing a fu�l 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 CommeI cement may result in your paying twice for
improvements to your property.A Notice of Commencement rt ust be recorded and posted on the jobsite
before the first inspection. if you intend to obtain financing,con,suit with tender or an attorney before
commenting work or_recording our Notice of Commencement
Signature of Owner/Lessee/Contractor as Agent for Owner Signature"of Contractor/License Holder
STATE OF FLORIDA STATE;F FLORIDAI
COUNTY OF� r COON OFlti%.•The for o'n instru nt was acknowledged before me
The for Ding instr ent was acknowledged before me _g g
this day of 20�by this Z ay of4/t/1420 by
1 el ::LLJ"el -_ - — , t]� �l
(Name of person acknowledging) (Name of pets n cknowledging)
n n
( ignature f Notary Pie -nState-of Florida) (Signatur of otary bfic- to of Florida)
Personally Known / OR Produced Identification Personal) Known �R Produced Identification
Type of Identification Produced Type of Identification Produce
> O
(l�lj3`J�1.r1111t � N al) _ t n No. �D�v f i I __ M e�dor�MMISSION#GG435 6
Commission No M1CfI. ElOO EXPIRES October OA,242
,a
,oF M;t
•`�MY COMM{ U43S648
•tilt.' INLS .11.2424
Revised 07/15/2014 ----
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS I
I ,.