HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE /INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -� Permit Number.
c ut>loing rermil Hpplsicauon
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PEKMI I AYPUCA I IUN FQR: To Select from dropbox, dick arrow at the end of line
IMPRLWEIVIEN I LOCM ION:
Address: 451 � c-ta l i e 'Dr
Legal Description:
Lo#No.
Property Tax ID ��a�-(olQ
Block No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: LeftSide:
III_ 1 AIL:EU UESUIP I ION UE W QKK:
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,� ke -Fa r I i% 3 �,z To n
►y.5 SE( P -
CONSTRUMON INFORMATION: _
on, wo o I rm un er is permit - c
JZ HVAC Gas Tank �as Piping
Electric [ Plumbing R Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ a 6
OWNER/LESSEE:
Pk J
0 l (J hr�a
rr-
Shutters ]Windows/Doors
Generator L] Roof
Sq. Ft. of First Floor-
Utilities:
loorUtilities: 0 Sewer O Septic
Name Jos MenAru tl;armen rerez i•1f-'Y1(kf W
Address: 330 RichbPli 'Rcr
city: n'1 awta r c roc c k State: N y
Zip Code: 10 5 L4 3 Fax:
Phone No. 914- u 7 4 6q5?
E -Mail:
Rli in fee simple Title Holder on next page ( If different
from the Owner Kited above)
CONTRACTOR:
Building Height
Roof pitch
Name: CU�T(S ,�t�Mvncri
Cam pang _
Cusn1 A ,rs�ste-1S
AddressD. 1 !,? t 5 E 1i, l l a4 rCity
t o R -T St . L vct t--- State:
Tip Code: a -452- Fax: 77J- 3S -i9 a
Phone No. -7 q�L
E -Mail: Cu StCxir S`ts Cool C�vr�
State or County license:
if value of const►vction is $Z50o or more, a RECORDED Notice of Commencementis requ6red-
SUPPLEM EN I AL C;UNS I RUC I (UN LILN LAW INFURMA I IUN:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State: f
Zip: Phone:
Zip: Phone:
BONDING COMPANY: Not Applicable
FEE SIMPLE TITLE HOLDER: _ _ Not Applicable
Name:
Name:
Address:
Address:
i
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation h;zs commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit :ill authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owr;ers Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Horne Oviners 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
it accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The follmkiing building permit applications are exon-ptfrom undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, :«alls, 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 Contracfor/License Holder
STATE OF FLORIDA ,; , i STATE OF FLORIDA
COUNTY OF `) ,�v C` i E ;COUNTY OF
i
The forgoing instrument :�ras acknowledged before me � The forgoing instrument was acknowledged before rine
this day of -IV r_y 20 18 by this d6 day of Ty< -Y ,20 18 by I
I
r C
(Name of person ackno-wledging } (Name of person acknowledging }
(Signature of Notary Public -State of Flgl a } (Signature of Notary Public - Stat of Flori daX
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced_ Type of Identification Produced
,J � J � YP I ll?� / n - 1' �� i rM1 �tY P(/i�� C,HRI`, i; r•' �-;''�
Commission No_ Ut G7 ` �„j J �tE^ a CHWS7INEBENt }}mission No. t7l
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MY COMMISSION #f 052516 S
we EXPIRES April 2021 Yg
- - r- -
- -- - - ��BENC,LiSH
9 t7► Ib B"ed Ttw Budget Na77 Sevires t - o
* MY COMMISSIO!t # GG 0525x3
*
Revised 0 /1S/301 1 �,.' Mn
EXPIRE 1a,2021
,o
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETA ZION SEA TURTLE MANGROVE �
COUNTER REVIEW 4EVIEb1'i REVIEW REVIEWREVIEW REVIEW
DATE
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COM PLETE
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INITIALS i