HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETER FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and !]evelopmertt Services
9uflding and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34.982
Phone: (772) 4621553 Fax: (772) 462.1578 Cbmmerciai
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PERMIT APPLICATION FaR;
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PRa`i?asE"D'°iN-,PROVEN N.T i_QCATI`QN,77
,
Address ``p n
Legal Description:
P ro pe rty Tax I D #; •1 CC���-C ��G •-
Site Pian fume: Lot No.
Project Name: Block No.
Setbacks Front___. Back: Right Side: Left Side:
DETAIL a D' CRIPTION. OF 1NoRK:.
CONSTRUCT,1IQN�lf9FDRMATLN,
�t ona war o e e Orme unde r this perm t — e ec a appy;
iHVAC Gas Tank ❑Gas Piping
[Ilectric
,Shutters []Windows/Doors
Plumbing 05prinklers 11
Generator Roof
Total Sq. Ft of Construction;
S Ft. of First Floor:
Cost) of} Construction.. $ , � � utilities;12SewerSeptic Building Height: _
VWNE°R}�EWS, "EE ww r
Name_
Address: 7
City: 1 �,
State
Zip Code:- Fax:
Phone No.
E -Mail:
Fill in feesimple Title Holder on next page { If different
from the Owner listed above)
If value of constructlon is $2500 or more, a
%.:v'ivA,M."A ITUK
Name: -J20 Al A,21gr4 i7fbA
ti
Company: ( f e.„A 6r7 'r' e ee q.8 r�C R/A C eo)
Address: 661 AIJ
City: 7)4'e”" l 7- L('(rI cr.• State: L
Zip Code: 3 - Fax: 77,2 `671- t -,F&
Phone No. 7�7sZ- 8-?,?- ..�Z/.
E -Mail. fV) >•,,- ' . . C) ,
state or County License:
D Notice of Commencernen+t is required.
Not
Name: I
Address,
City, State:
xlp: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City: ...
Zip: Phone:
MORTGAGE COMPANY:
Not App lica
Name:
Address:
state:
City:
ZIP: ---M Phone:
BONDING COMPANY:
—Not Applicable
Name:
Address:
City:
Zip, Phone:
I certify that no work or installation has commenced prior to the issuance of a permitp
St. Lucie Coun�y make na representation that is granting a permit will abylav s Qr and covenants that maerto y restrict
pro lbit such
which is in confllctwit. any applicable Home Owners Association rules,
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 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 first ins ee ion. if you intend to obtain financing, consu n attorney before
A>~r� r r1r recur 1 ur Notice of Commencem
Signature of'Owngrl Lessee/Agent
a
STATE OF FLORIDA -% it Z
COUNTY OF_� i _�„ � �C�� -r.W-
The forgoing Instru ent was acknowledged before nq &
this-byday of fit) . a~ �� �p
I (Namepf person acknowledging) hl�
(g ature of Noiary Public- State of Florida)
Personally Known OR Produced identification
Type of ldentificatlon Produced
Commission No.)—R�Jl (seal)
Revised 07/15/2014
REVIEWS I FRONT ZONING
COUNTER REVIEW
COMPLETE
INITIALS
STATE OF Pi.Oit U a� >
COUNTY ail` r ' 3
The forgoing instrument was acknowledged before m �„ 12 Q
this _aday of . 20 - by � ® S
Personally Known I./ OR Produced identification
Type of identification Produced
Commission No,� r I (Sea 1)
SUPERVISOR l PLANS I VEGETATION I SEATURTLE 1 MANGROVE
REVIEW j REVIEW REVIEW REVIEW REVIEW