HomeMy WebLinkAboutCCF01242019ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /- aZ / 9 Permit Number:
Dwaing rermit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 402-1553 Fax: (772) 462-1578 Commercial Residential
PEKMI I APPLIC:A I ION FOR: To Select from dropbox, click arrow at the end of line
PROPOSEV IMi'KOVEMEN I LOCAI ION:
Address:
—T
Legal Description:
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
UE I AILED UESCRIP I ION OF WORK: j
I
CONSTRUCTION, INFORMATION:
lid F io wor o e er formed -un er this permit -check a appy:
HVAC Gas Tank ❑Gas Piping _ti Shutters []Windows/Doors
Electric F-1 Plumbing Sprinklers F] Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: Sewer Septic Building Height
OWNER/LESSEE:
CONTRACTOR: _
Name Ae4a Name: CUVCCTIS ,5-A6L 0AcnS
Address: oqgo tv Company: &.CS -Ta m_ A , r �l s t ems (r"� C..
City: 'Pod S't urie. State: FL Address: -14,1 5 S E ew_e reei't
Zip Code: Fax: City: F5 2T 9t . L uci State.
Phone No. 772 al. 2 SD o ZpCode: 3-+159.- Fax: 7`iJ- -135-19 �
E -Mail: Phone No. 79 � 3 3:5 -
5Fill
Fill in fee simple Title Holder on next page ( if different E -Mail: 0- u s t &
from the Owner listed above) State or County License: co 51 F ( 0
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLENIEN IALCUNS I RUC IION LIEN LAW INEURIVIAI IUN:
DESIGNER/ENGINEER: — Not Applicable
'MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: Slate:
Zip: Phone:
; Zip: Phone:
i
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address: l
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation :gas 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 Nome Osmer s Association rules, byiar.s or anci covenants that may restrict or prohibit such
structure_ Please consult %,jith your Home Owners Association and review your deed for any restrictions vihich 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 vAth the approved pians, the Floncla Building Codes and St. Lucie County- Amendments.
The following building permit appfcations are exemptfrom undergoing a full concurrency review: room additions,
accessory structures, stiL4mming pools, fences, .va ls, signs, screen rooms and accessory uses to another non-residential use
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