HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .1- 7 Permit Number:
•
auillaing vermit Hppiicavon
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
i
j PEKMI I APPLI(;A I ION FOR: To Select from dropbox, click arrow at the end of fine �
PHUPOSEU iMPKOVEMEN I LOC:AI ION:
Address: ��D� /✓D c ���.� �//L
Legal Description,:
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DE I AILEU UtSC RIP I ION OF WORK:
Z'lhe /L,r L,/!t
[CjON�STRUCTION INFORMATION:
or o e e rme under this perm!t—c ec a - app
!ZHVAC Gas Tank ❑Gas Piping _ShuttersWindows/rpoors
U Electric Plumbing Sprinklers El Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $_y y75-- _ Utilities:F]Sewe r 7 Septic Building Height
OWNER/LESSEE: -- - — CONTRACTOR: ---
I Name ' A Name: /�ri.'+�T( S sit akoAC(7L
Address: 7-62d` l h!A4W Z2,Kk L Company: C 11 S?o nit A r u
City: Ani. J-Y &e _ State: FZ_ Address,. l lP I S S E ��; I
Zip Code: ,���Sa- Fax: City
I C�PLT ,St, j_uCi� State: r — i
Phone No. Zip Code: 52 - Fax: 57-1 9i
E-Mail: Phone No. 711 3 3 S - 3 3 2-
Fill in fee simple Title Holder on next page( if different E-Mail: C u S t cL! r- s ti s cc n I C u vn 1
from the Owner listed above) I 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 ION LIEN LAW INFURIVIAIIUN:
DESIGN ER/ENGiNEER: _Not Applicable I MORTGAGE COMPANY: _Not Applicable
Name: Name: '
Address: Address:
City: State: City: Slate:
Zip: Phone: Zip: Phone:
t _
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name: I
Address: Address:
City: City:
Zip: Phone: up: Phone:
I certify that no work or installation items commenced prior to the issuance of a permit
St_Lucie Countrmakes no representation that is granting a permit v:ill authorize the permit holder to build the subject structure
v:hiclt is in conflict with any applicable Home Owners Association rules,bylavas or ano covenants that may restrict or pr chibit such
structure-Please consult:rtth your Hone O<.nersAssociation and revie.v�your deed for any restrictions which may apply_
In consideration of the granting of this requested permit,I do hereby agree that I:vill,in all respects,perform the v:ofk
in accordance vAth the approved plans,the Florida Building Codes and St_Lucie County Amendments.
The folio-wing building per nist apphcat:ons are exen.ptfrom undergoing a full concurency review:room additions,
accessory structures,stmmming pool,fences,.«a?ls,signs,screen rooms and accessory 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 attomey before
commencing work or recording your Notjce-of Commencement.
Signature of Ov1,ier/�essee,'Contractor as Kgentfor Oc':ner Sip ature of Contrac-,orlLicense Holder 1
STATE OF FLORIDA STATE OF FLORIDA ,
COUNTY OF i COUNTY OF
I
The forgoing instrument_-zas acknovFledged before me The forgoing instrument was acknov:ledoed before n;e
this _day of /L?f40Cft 20 LTb.� i this_Z day of MfCC/-f 120 1 by
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(Name of person acknowledging j I (Name of person acknotsledging�
(Signature of Notary Public-State of F crida j (Signature of Notary Public-State of lorir: )
Personally Known ' OR Produced identification Personally Kro.m OR Produced Identification
Type of Identification Produced Type of Identification Produced j
vJY Allp CNRI�'^ -r r i} Ism
Commission No- ?9 CHRISitNEBEN t
I�Fhmission No_
* * MY COMMiSSION 9 G Q52546 _ 321
m e EXPIRESApd . t2711
jt o BorFeGTieu Budget Na7sySenires t •-�•••. n
Revised 0711_:2014 * fin'c XPIR ssiau 4123,2130
,2021zSa
m�� P�o� EXPIRES:Aprfi 4,202t
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REVIRAIS FRONT ZONING = SUPERVISOR j PLANS VEGETA i iON I SEA TURTLE MANGROVE
COUNTER _ REViEW REVIEW I REVIEW REVIEW � REVIEW REVIEW
DATE
COMPLETE
I N FFIALS i