HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7 Permit Number:
r
oullioling vermin 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
FERMI I APPLICA 1 IUN FUR: To Select from dropbox, click arrow at the end of line j
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PROPOSED IMPKOVEMEN i LUC:AI ION:
Address: - — /6i'o
Legal Description,:
Property Tax ID ti: J?e -'«-As12 DDoIS Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
I DE I AILED DESCKIP I ION OF WORK:
CONSTRUCTION INFORMATION:
i a wor to e e orme under this permit—check a apply:
i HVAC Gas Tank []Gas Piping _Shutters �Windows/Doors
Electric Plumbing Sprinklers Fi Generator Roof Roof pitch
Total Sq. Ft of Construction: )c Sq. Ft. of First Floor:
Cost of Construction: / L Utilities: Sewer[]Septic Building Height
OWNER/LESSEE:-- ------ CONTRACTOR: —
Name TAerlcal v /50'n "I' Name: Cii rpTI S 'S-rl4k0AcnS
i
i Address: /6" `flo ti Cam parry: CuS��nt r SuS .te��C
City: Fo�Lt/��cF�t,�� State: FG Address: IRIS E ��; 11 eta- _�'r ?ea
Zip Code: �9�5 Fax: City- Cc R-T ,St- L v=� State. F_--
Phone No. e3sa —S9A— 6eog Zip Code: 3 l571 Fax: ` "1.?
r-Mail: Phone No.
Fill in fee simple Title Holder on next page( if different E-Mail: C K s t c'i r s -' s
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. --- --
SUPPLEMEN I AL CONS I RUC I[ON LIEN LAVA INFURMAIIUN:
DESIGN ERJENGINEER: Not Applicable MORTGAGE COMPANY: —Not Applicable
Name: Name:
Address: address:
City: State: City: Slate:
Lip: Phone: i Zip: Phone:
i _
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name: 1
Address: Address: ;
i
City: City:
Zip: Phone: Lip: Phone:
I certify that no work or installation has commenced prior to the issuance of a perr-iit_
St.Lucie County_makes no representation that is;ranting a permit will authorize the permit holder to build the subject structure
v:hich is in conflict with any applicable Home Ci..wers Association rules,byla%vs or and covenants that may restrict or prohibit such
structure.Please consult.wth your Home Oviners Association and revie_y your deed for any restrictions which may apply-
In consideration of the granting of this requested permit,I do hereby agree that I.�il[,in all respects,perform the work
in accordance e;ith the approved plans,the Florida Building Codes and St_Lucie County Amendments.
The folio Ang building permit applications are exen:ptfrom undergoing a full concurency review:room additions,
accessory structures,stinmming pools,fences,..falls,signs,screen rooms and accessoR,uses to another non-residentiai use
WARN iNG 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 redo-ding your Notice of Commencement. _
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Signature of Oy+ner/LesseejContrcior as Auenttor Oa:,ner I Sio ature of Contractor ikense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _" i COUNTY OF
1
The forgoing instrument:eras acknovJedged before me 1 The forgoing instrument was acknowledged before n:e
this_L day of 0 fi 2C ft 20 j _by 1 this_7 day of (.f�l f e Lt '=a �by
1
J
t
(Name of person acknowledging'
� (Name of person acknotsledging)
(Signature of Notary Public-State o PCriria j (Signature of Notary Public-State of Flour:
i t
Personalty Kno.yn OR Produced Identification
I Personally Known OR Produced Identification
Type of identification Produced Type of Identification Produced
? -Y - ~�' `
Commission No_ q CHRISNIEBEN thrnission No- ! Y * h'� ? f �G
* * MYCOMMISSION3 GV52w C' _ )21
wt EXPIRES:Apr�2U1
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Revised 0;r 15i2014 �T�_ `o� WHUZ:AK4,2Ul
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REl'IEl^!S FRONT ZONING
' SUPERVISOR T PLANS VEGETATION SEA TURTLE�FVIANCGROIV�E "'j
COUNTER REVIEW REVIEW REVIEW REVIEW I REVIEW REVIEW I
DATE
COMPLETE
INITIALS