HomeMy WebLinkAboutBuilding Permit Applicational 1 appl Iraw F INFn MI IST RF rnmpi FTFn FnR Appi irATlnN Tn RE ACCEPTED
Date:
Permit Number:
Building Permit 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 1/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Description:
Property Tax ID#: 04 0a67- DOO - _ Lot No.
'Site Plan Name: V�0�1�1 C'-1 e.— Block No.
Project Name: S0u-LC1 e_r-
Setbacks Front 'go / Back: AJ -Right Side: 1lr Left Side:
38 F-F o-f� to -F4- h h PVC, 4 4ic_e, w I +k 4 -Pf w i d -e s t �-)3l e
❑ HVAC
❑ Electric
_ "Shutters
❑ Plumbing Sprinklers I Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 3 (POD
S Ft. of First Floor: _
Utilities: Sewer E]Septic
❑ Windows/Doors
Building Height:
r gs
C}U11NER%LESS E t P �
..Y<� �,tea�a-.�r? a9 3A,
a a
GENT GT+OR$ g
Name c 0.k-_& @'_
Name: e,5
Address: /?R AJE /U ICL AV24'A-� 1L
City: PO rf 54- LLIC-1 e- State: fLL
Zip Code: J*q9.J� Fax:
Phone No. F&n -o214-- (p3oZ3
_M
Company:
Address: PO 60 x ab,56
City: 5�_t.�_F State: -EL -
Zip Code:,34 96 Fax: -771-,9-99-3o3S
Phone No. `7 7 dt - X R(?- 01-/
E-Mail:54L0ur+re n o-6 Ab P0/-1I 5c4n - 0 e_+
E-Mail: -
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: ob l� %8`
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
P ig e"""rxa iqC� ' '✓" C 4p'., } "E 5 ,£ fi i z4` ' a^ . ' Y� °o'�'a¢
;S�l�P,L ME�11AL CQNS�I U
.{ •. .} ra"�P'aYik K£, 41w,
F
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has 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 Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which 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 with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING 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 n attorney before
commenciDg,work oVecording vour Notice of Commencement. — /
as Agent for Owner
STATE OF FI
COUNTY OF
The for�ing instrument was acknowledge before me
this W—d` ay of 20 by
i
Signature
STATE OF FLORID --A ff.
COUNTY OF
The forg ing instrument was acknowledged before me
this ��PX ay of - . 20 i3 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State of Florida) (Signature of Notary Pub ic- State of Florida )
Personally Known L/ OR Produced
Type of Identifi
Commission N
Revised 07/ 15/2014
Notary Public State of Florida
Diane K Bond ��ccPPaa����
Myeommission GG'Z MI
Expires 1212812022
Personally Known OR Produced Identification
Type of Identification Produced
Diane K Bond
F u„ commiukx rc
E=lres 1212812022
Of
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS