HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7- � y _/ 91 Permit Number:
•
nuiioling rermlt Hpplicavon
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
PEKMi I APPLICA I ION FOK: To Select from dropbox, click arrow at the end of line
PHOPOSEU IMPKOVEMEN I LOCAI ION:
Address: g a 5 D /J lji w �A I A jq pt a 0 3
Legal Description:
Property Tax ID #:a3_ SDS' 0� �m�l� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
UE I AILED UESCKIP I ION OF WOKK:
L �l7 /L� t �I �L {- � �n ✓� /�,5��j p %,� Sys �. JJ� � / ` �
CONSTRUCTION INFORMATION: _- _--
o worko e performed un er is permit – c ec a app y:
1:1 ❑Gas Piping Shutters Q Windows/Doors
HVAC Gas Tank _
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3 Utilities: Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Sane
Name: A (V O'l e 0 5 j
t
Address: 5596 7rowbrt�g-P_ Dr
Company: uLo-am A , Sus eve S c,
City: D N w o6 der State: Gi A
Add res d4 -t a r ee i1
Zip Code: 30.33S Fax:
City: Po RT St . L vci ,e-- State:
Phone No. y C q " 3 �5 - V c6 o
Zip Code: 3`F452. - Fax: 77J- .j .35- igt
E
Phone No. T] l 3 3:5- 3 2 3 1
-Mail:
FH in fee simple Title Holder on next page { 11different
E -Mail: C u S t
from the Owner listed above}
State or County License: C G' s 8 ( C
— �- - -
If value of construction is $25oo or more, a RECORDED Notice of Commencement is required.
! SUPPLEMENIALC:UNSIRUC IION LIEN LAW INFORMA I[ON:
DESIGNE
Name: _
Address:
City:
Zip:
IIL140 x c ► . = sne N175
Phone:
State:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name: I
Address: Address:
City: City:
Zip: Phone: Z-1 P: Phone:
I certify that no vrork or installation has commenced prior to the issuance of a permit.
St. Lucie County 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, bylauvs or and covenants that may restrict or prohibit such
structure. Please consult with your Nome 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 plans, the Flonda Building Codes and St. Lucie County Amendments.
The folimking building permit applications are exemptfrom undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, wa--Is, signs, screen rooms and accessonr uses to another non-residential use
WARN ING 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/ -essee,•`Contractor as Agent for O.vner ( Signature of Contracor/License Holder
STATE OF FLORIDA j STATE OF FLORIDA
COUNTY OF 6Y /— u C' I E I COUNTY OF
The forgoing instrument :vas acknowledged before me j The forgoing instrument was acknowledged before me
this SYS day of 0-o LY 20 1,? by j this a(/day of _ ,YLlz:y 20 ! P• by
In Ir ! L! ft (J v t Ir HYlc'
(Name of person acknowledging ) i (Name of person acknowledging)
}
i
(Signature of Notary Public- State of Flc} a }
t
Personally Knmvn OR Produced Identification
Type of identification Produced_
Commission No_ fil G7 �' ✓� �f E" rq a' CHRISTINE 8
(Signature of Notary Public -Stat of Flor
'/
Personally Known OR Produced Identification
Type of Identification Produced
'7 - r
ENW§Hi mi ssion No- Li �i c) �� ✓l1 (%'
* # MYCOMMISSION#(GG052546
a1� EXPIRES: Apra! 4.2021 _
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}b0 Barided T7vu Budget Natry Services
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Re --iced 071'1-;i2014
REVIEWS� FRONT ZONING
COUNTER REVIEW
COMPLETE
INITIALS
SUPERVISOR i PLANS
REVIEW ' REVIEW
CHR�••+�ir ��
r C• '
* * MY COMMISSION* GG 052M
EXPIRES: Apri14,2021
VEGETATION I SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW