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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: viol ouilloEng r-ermlt App kation Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 345132 Phone: (772) 402-1553 Fax. (772) 462-1578 Commercial Residential PEKMI I APPLICA i ION I -OK: To Select from dropbox, click arrow at the end of line PROPOSED IMPKOVEMEN I LQCAI ION: - --- - t ka Address: /D 6 G 0^ c Legal Description: Property Tax ID eZ3a -// �,'(DDO�' 0�� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back. Right Side: Left Side: UE I AILEU DESCKIP I ION OF WORK: ' 71t 2 CONSTRUCTION INFORMATION: a work to a rme un er t is permit - c eC a =Lftte�rsWindowsjDoors Gas Piping i HVAC L Gas Tank _ Electric Plumbing Sprinklers Generator []Roof Roof pitch Total Sq. Ft of Construction:// Sq. Ft. of First Floor- loorCost Costof Construction: $ / Utilities:11 Sewer Septic Building Height OWNER/LESSEE: ----- { CONTRACTOR: Name � Name: C U IP --r Lr, 6oAC (7 i Address: /� /�D ©1��eC�0,�22, /1Cd Company: Cu5-r6rpt A 5u 5 S i mac, City: State: Address: l lY15 �l, I dG �r-ee a i Zip code: Fax: i ciy: COILT SL Lucite State: Phone No. 77a- y' i 9 D Zip Code: a+,? 52 - Fax: '77,2- 77J-E-Mail: E-Mail:Phone No. i '1 Z 3 3:5 - SFill Fill in fee simple Title Holder on next page ( if different E -Mail: C u s t C, t r- at o i L c. rti from the Owner listed above) State or County License: n J i F C - - - — if value of const ruction is $2500 or more, a RECORDED Notice of Commencement is required. 052545 SUPPLEMENiALL:UNSIRUCIION'-LIEN LAW I NFURTVIA I ION: DESIGNER/ENGINEER: _ Not Applicable ` MORTGAGE COMPANY: _ Not Applicable j Name: j Name: Address: ',Address: City: State: i City: State: Zip: Phone: i Zip: Phone FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: ! Address: Address: C! City: Zip: Phone: Zip: Phone: I certify that no vvork or installation Chas commenced prior to the issuance of a permit St_ Lucie Countvmakes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Os.rers Association rules, bola-:s or anct covenants that may restrict or pr ohbit such structure_ Please consult Ah your Home Owners Association and revie -your deed for any restrictions -which may apply. In consideration of the granting of this requested permit, I do hereby agree that t :-ill, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St_ Ludt County- Amendments_ The folioxdng building permit applications are exemptfrom undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, Aa'ls, signs, screen rooms and accessory uses to another non-residential 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 lobsite before the first inspection_ If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement. Signature o. Q-:ierf--essee,CortraCLor as Anent for O-, ner I Signature of Contractor/License Holder STATE OF FLORIDA + STATE OF FLORIDA COUNTY OF f " `- _ ! COUNTY OF - i The forioim instrument was acknowledged before me I The forgoing instrument was acknowledged before n.e qday this i, J day of an tiLF 20 L_t2b>• I this / of ),42k ,20 L by I (Name or person acknowledging) r (Name of person ackno<<:izdging ) (Signature of Notary Public- State of Pcr;ria j (Signature of Notary Public- State of qorida i Personally Knosvn OR Produced Identification Personally Known OR Produced Identification Type of identification Produced Type of Identification Produced j - °0 YP` , Ckr�1s K i? i i Y 'P{.� CHR157tNE B EH - r - .: •. _t Commission No-'-. _ _ - - rq �L�f I�Fhmission No. _'' * • --_ MY COMMISSIONS G 052546 -:Xw, cora c EXPIRES: Apr -- 7rtAYG9 gE]"�GLMF 0►[:64 BargedTMt '8.14�9'I riSLPf SRIY"..PS t �•••�'�/p *_;\ MYCOMMISSIMNIGGM50 * Revised G7il�i2G1 °E7�1RES:Apr74,2021 REVIRAIS FRONT ZONING SUPERVISOR PLANS : VE6CTA T iON I SEA TURTLE iVi.ANGROVE COUNTER = REVIEW i REVIEW REVIEW ( REVIEV%r REVIE\N1 REVIEW I DATE = l COMPLE T E INITIALS Il ---- - 052545