HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address -
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State: T
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone -
I certify that no work or installation has commenced prior to the issuance of a permit
St. Lucie Counmakes no
which is in conflict with an
structure. Please consult v
_Not Applicable
m thepermit holder to build the subject structure
or and covenants that may restrict or prohibit such
deed for any restrictions which may apply.
In consideration of the granting of this requested permit, l do hereby agree that 1 will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from 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
Signature of Own en Lessee
STATE OF FLORIDA
COUNTY OF �1� t
The forgoing instrument was acknowledged before me
this _%L dayofJaMJdA244 . 20 W by cit/
(Name of person acknowledging j
(Signature of Notary Publ" - tate of Florida )
Type of
Notary Public - Stale of Florida
Commissinn M GG9
My Comm. Expires Aug 21, 2020
Revised 07/15/2014
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Signature of Contractor/license Holder
STATE OF FLORIDA
COUNTY OF a. We"
The forgoing instrument was acknowledged before me
this day of -f
Mill&a4 20_j4 by ew
i4
BaqL
(Name of person acknowledging)
4. anw"'g,/
(Signature of Notary tic- State of Florida)
Personally Kno �' p�IGidJioG
Type of Identili-on,R4q¢yced CHRISTINE J.
i°; Notary Public - State of Maincommission No "` Commissiol("017839
q Comm. Expires Aug 21, 2C
ded Ohrouoh National Notary As
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
ALL APPUFAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i i x h "1 - Permit Number:
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 III
PROPOSED IMPROVEMENT LOCATION: 11
Address: Wf10
Legal Description:
Property Tax ID#: 15- o - 5ox- 00-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
I�r(C2� Utc&: "jAStrkt( V)tW QWr,MXV1 3 Fon tu-S0PR
sfti-i'Ale, 5t 6tem wrWl tD KW hear.
CONSTRUCTION INFORMATION:
Additij(hal work toe performed un ert ispermit-check all appy:
_ HVAC Gas Tank []Gas Piping _ Shutters ❑ Windows/Doors
1-1 Electric El Plumbing [_]Sprinklers Generator 0 Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 3A oo . o D
SFt. of First Floor: _
Litilities:n Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name TOe
Name:
2rQ�'.L,,,i�t/". "_P'm"t�
Addre�sps: �-5 Rxyrt,rl OV151, �ucL `�t, t
Company: fi)
City: V o 8Q,acl,1 State
zip Code: '324 (p3 Fax: SIA
Phone No. - R5l-
Address:SIDS1 u"Pi16& Cutler
city, Y'l'Lf c e State:
Zip Code: 3MI5`1F�t� Fax: 111- 94t&-3737
P5101 _
E-Mail:-WAPhoneN''o.7%��N(P�-`Ii�t
Fill in fee simple Title Holder on next page t if different
from the Owner listed above)
E -Mail: ►w (2Q.0 P, \lA h ov . Lf ry%"
State or County License: 11,kI?1i318L
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.