HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: " a3' g Permit Number
auming rermn Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-2553 Fax: (772) 462-1578 Commercial Residential
YtKMI I Ai PPCA I ION FOR: To Select from dropbox, dick arrow at #tie end of lime
PROPOSED IMPKIOVEMEN I LOC:AI ION:
Address: I l 0 E h(iP_cS
Legal Description:
Property Tax ID #: OlO " Doo - 3 Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back:
DE I AILED DESC;KIP I ION Of- WOKK:
CONSTRUMON,:I.N PORMATION:
Right Side: Left Side:
/ �Sele(I G'1APJC_ -o-OT,
HVAC LlGas Tank L6as Piping U Shutters
Electric 11 Plumbing Sprinklers Generator
Total Sq. Ft of Construction: / Sq. Ft. of First Floor. —
Cost of Construction: $ 10.2 ' � � Utilities: 0Sewer OSeptic
OWNER/LESSEE:
Narri-G- L13 O-\ Y\<t'
Address: t IW t nACE% (LOQ CL
C-,tT. �p r.4.- Q; e c -c 2 State: L
Zip Code: Fax:
Phone No. I 10L ' `lC-V�Q-
E -Mail•
Flit in fee simple Title Holder on next page ( N different
from the Owner fisted above)
CONTRACTOR:
Block No.
?
❑, W indows/Doors
QRoof Roof pitch
Building Height
Name: GU�Zt S ,Sncyncns
Company �us�'a n1 t� r �4 s erKS ( c-
Address: (4pt$ S E v/r l
F�0 P -T 9t . L u ct t—, " State:
Zip Code: 3-4-R 59. - Fax: '7 Tj d 3 57 i 9 � a
I
Phone No. 'i 11
E -Mail: C u St C� t r stir Coot - C (' VYL j
State or County License:
it value of construction is $2500 or more, a RECORDED Notice of Cony er cement is r Kp*ed.
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SUPPLEMEN 1 AL CONS 1 RUC I ION LIEN LAW INI-ORMA 1 IUN:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State: `
Zip: Phone:
i Zip: Phone:
i
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable i
Name:
Name:
Address:
}
Address: i
City:
City:
Zip: Phone: I
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countv makes no representation that is granting 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.
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 pians, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exemptfrom 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 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 Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder :.
STATE OF FLORIDA STATE OF FLORIDA r� .
COUNTY OF
a C` I it COUNTY OF
i
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me j
this 1 S day of 20 18 by this day of -0 IV by
_ t.Ct:1 Vj4yY1;:;
(Name of person acknowledging 1 (Name of person acknowledging)
I
(Signature of Notary Public- State of Fic,�.ma } (Signature of Notary Public- Stat of Flor- i
Personalty Known ✓/ OR Produced// Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
)0 P4"' GHR*TiIW ' ' I!
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Commission No_ -6f 6 5, ' 7 � rc Ya° CH�M B mission No. A & 0 y � J • 7 L +� ' p;v -*,:4- . • ..., : t 1
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW I REVIEW REVIEW REVIEW REVIEW
DATE
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COMPLETE
INITIALS
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