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HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G L,1 Date: Permit Number: 1 i o' ' MEN Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)4621553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: O Legal Description: Property Tax ID#:� `� "��� ^" �/ ^ o0c) Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: K)2 Czt_o f comma �57 1`A- �e k itioa war to e e orme un er t is permit—check a app y: HVAC Gas Tank Gas Piping _Shutters Windows/Doors 11Electric ❑ Plumbing Sprinklers Ej Generator Roof Roof pitch Total Sq. Ft of Construction: SFt. of First Floor: T Cost of Construction:$ u Qo Utilities:11Sewer El Septic Building Height: Name Name: Address:Cr5q�I5 Company: 1 ►Y l E City: n 4� � State: Address.LG l k 1J t-L:) P(,,p r e C �- L") Zip Code: +_&1)4f'K Fax: City: 4N IR+a ki tie State: rL Phone Noc)?1_ — (Va / (PI-VP Zip Code::Z>LgWo Fax-. 77997?-,5/44 E-Mail: PhoneNo. 27a-376' -51 3 Fill in fee simple Title Holder on next page (if different E-Mail: (� R t,L a Q,(-QQ_LY)P_ -n m from the Owner listed above) State or County License: LS If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required. 'K: � JY.','it. .F:ac.G � i?'✓1. t.A \ ,F� S' _ .. R w�a. �..: Dt:51GAlER/ENGINI:I^R: hot Applica Ee 11�pRTGAGE COMPANY: Q�ot�1pp(icahle Address: Addra: i City: State; � City: Zip: Phone; zip: FEE SIMPLE TITLE HOLDER; �Not Applioble 6ONbINfi;COMPANY., ,.,,Not Applicable Name: Name: Address: Address: City: City: l Zip: Phone: Zip: Phone: } i certify that no work or installation has commenceo prior to the issuance of a permit. ] St.Lucie Counter makes nor ppres tatio that is granting a permit will ,uthonZz tt.e grrng holder to build the wbject structure i} which is in conflict with any applicaie home own�rs Association ruleis,�ylaws of an covenants khat may mulct Or prohibit such ! structure.Please consult Inrith your' ome Qwners ssociation and review your deed or any r itrlcfiom whit. may apply. 3 in consideration of the granting of this requested permit;I do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,the Florida Building Codes and$t.Lucie County Amendmghts. g� The following building permit applications are exempt from undergoing a full concurrency Peview:room additions, accessory structures,swirniming pools,fences,walls,signs,screen rooms and accessory uses W another non-residentlal use WARNING TO OWNER:Your f0ure to Record a Notice of Commencement may result i�i your paving twiEe for is improvements to your property,A Notice of Commencement must be reccirdeo and posted or,the;ob$i% before the first inspection, If you intend to obtain financing,consult with lender Qr an attorney before cornmencing,work or recording your Notice of Comm .. rernent. 1 _$i�n9 er/i asse %Agent S$ . on ctartCii Qhsa MoSder E STATE OF FLORIDA STATE OF FLORID COUNTY OF_ 471lNTY OF ,t J ' +r� hefor$oing instru e;u was acknowledged before me 71%e foreging Instrument was ac{trowledged tlefore me this day of / 20 �by this ay Of zo , by (Name 0 person acknowledging (Name of person ackn��yledEielg')"1 �.ignaiure 9`Nota!Y Pub{s-St9ffi� 14ri_a, , I r,�tura :YAEsrY Rgoll'�- t9 6}©r�da i } Personally Known_ X. ,OR Produced Identification PerSanclly stnown _OR Araduced;dentification Tyoa of Identification Produ• d s Type of Idantificatign Prol�Uced- �"' . I f ` GENA LORENZ RUF. S$R it . . . .. gr;rrrr�lssio�,i�lo, cal) N6141y Pub C- a Of Rorf a ;r --,;�.. 7RA LORENTAUF i l_. commission+P FF 957967 1 c hOtdry Pu6gG Stilts ON Florida j My UP"s s>a 7, MY A Comm.Ex Ires Feb 7, 2020 REVIEWS 1 FRONT 3QNING SUPERVISOR PLANS VFGETATION ��ATURiLE MAAiGROVE CQUNTER REVIEW REVIEW REVIEW REVIEW � REVIEW REVIEW OAT �- -- i COMPLETE j INITIALS