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HomeMy WebLinkAboutBuilding Permit ApplicaitonALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: .2�'/ Permit Number: • ouiiai(lg rermn Applicavon Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 V Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PEKMI I APPLICA i IUN FOR: To Select from dropbox, click arrow at the end of line PRUPOSEU IMPKUVtMEN I LOCAI ION: Address: Jal Legal Description,: Property Tax ID #: �3D��6D�- D�,� �D© Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: LAc Pr L %1Z e - 2 •S l;;^on /� Seel C "S -c -our 1.5 /,/1,/ CONSTRUCTION INFORMATION: J Addition work to be pertormed under this permit — check a[ I appy: VAC F] Gas Tank 13 --as Piping Shutters Windows/Doors Electric FlPlumbing El Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ ALO OWNER/LESSEE: Sq. Ft. of First Floor:_ Utilities: F� Sewer E] Septic Name 0.144I5 a ,(fODA&1 1/lI6/,P-r Address: 7705 /*y F/1 t Aa;e C� State: F L City: _ Zip Code: 3 49S1 Fax: Phone No. '77a- or '77a- %4 - 1 S 1? E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Building Height CONTRACTOR: Name: C(:iT(S SArltiAcnS Company: C t,( 3 --a m A� r Li S e;'lll S tic. Address: 14715 S E 11; 1 ; ee i1 Q City: �'0 fZT .9t . I_ L, c State- r� Zip Code: `fgf SZ Fax Phone No. T1 3 3.5- 3 2 3 �- E-Mail: Cu SIC1ir $ 4-- C'. C' CGvrt State or County License: � C C.' 5 i IF If value of construction is $2500 or more, a RECORDED !notice of Commencement is required. 05W6 SUPPLEMENIALCUNSIRUC IION LIEN LAND INEURMAIION: DESIGNERIENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: address: City: State: City: State: Zip: Phone: i Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: i Address: Address: I City: City: Zip: Phone: Zip: Phone: I certify that no .,cork or installation has commenced prior to the issuance of a perr-nit- St- Lucie County makes no representation that is jrnting a permit v.,ill authorise the permit holder to build the subject structure Association rules, by lams or and covenants that may restrict or prohibit such which is in conflict with any applicable Home Ov.,nercture- Please consult Ath your Home Owners As strussociation and revie_v 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 pork in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The folloving building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimrning pools, fences, A.,a'Is, signs, screen rooms and accessoR, uses to another non-residentiai use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property_ A Novice 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 rico-ding your Notice of Commencement. i _l Signature of Oviner/.essee'Contractor as Agent for 0%vner j i� Signature of Contrac-Lor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF i COUNTY OF i The forgoin¢ instrument :vas acknowledged before me The forgoing instrument was acknowledged before me this day of 20 i _ i I this l day of 20_ by (Name of person ackno% iedging) (Name of person acknowledging j I (Signature of Notary Public- Ste E- of F erdda (Signature of Notary Public State ot cloricy= : Personally KnovLm OR Produced identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced ��cY?�y � i Commission No- _ ' - c. I4o CHRISTINE BF� ,0; pUp4 CFiRM''V y}ia mission No. r- ,n t r-j `� '114 # G 052546 : * MY COMMISSION f mr EXPIRES.Ap, 2021 SOI fbC 2anAeC Thv &x'ger H•'..2ri Seiv'sc * "4 MrcoltiMissrof�2 N�cc;a Reused G7 /15 i 2G 1 * , J WIRES: 5"'_4.2021 TT �o a. REVIEWS 1 FRONT ZONING ' SUPERVISOR I PLANS ` VEGETATION ! SEA TURTLE MANGROVE � COUNTER REVIEW j REVIEW l REVIEW 1 REVIEVY REVIEW REVIEW DATE COMPLETE - f INITIALS 05W6