HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
s
owilaing rerma App icavan
Planning and Development Services
Building and Code .Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 349811
Phone: (772) 462-2553 Fax: (772) 462-1578 Commercial Residential
PEKMI I APNLICA I IUN FUR: To Select from dropbox, click arrow at the end of line !
PRUPUSED IMPROVEMEN I LUCAI IUN:
Address:
Legal Description:
Properhi Tax ID �.�a� J`l/� ��/a��_ �iGD-� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
ED:[A ILEU DESCKIN I IUN OF 1iVUKK:
Lllf�- /��� Llh� _ �,� Sys«r C�,nr�� �� s-k�✓
CONSTRUCTION INFORMATION:
Ttio a wo— Te er�oFrried under this permit -- c�FieckaI I appy:
HVAC FGasTank ❑Gas Piping _Shutters 0iNindow:s/Doors
Electric Piumbing Sprinklers El Generator 10 Roof Roof pitch
Total Sq. Ft of Construction:: Sq. Ft. of First Floor:
Cost of Construction: $ %'��`� Utilities: 0 Sewer Septic Building Height:
OWNERAESSEE: 'CONTRACTOR:
Name rifend�eEZ3lSho /filar-ks Name: UCcTI SAn. 0'\Cn�
Address: 6 8 40L a D- i&&A o Company: L(5 -F& m A s u S ems
City: Q M &C1 CA State: F�- Address: 1471.5 S E 11 r l I etQ _e r- ee rk �� r
Ic P r St . L c i t State:
Zip Code: ;� 3 �( 8 _Fax: I City:
Phone No. 3�'� 6 I l ' Zip Code: `Fg5z Fax: 77,? 35
E-Mail: Phone No. T1 a- 33 6-
- 3 2 3 2
Fill in fee simple Title Holder on next page ( if different E-Mail: f- t cti i r Sys 4 Cc C • c c<<�ti
from the Owner listed above) State or County License: Ct C C? 51 F5' ( C)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEM EN I AL CONS I RUC I ION '-LIEN LAND I NLURNIA I IU N:
DESIGNER/ENGINEER: _ 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:
Address:
Address:
City:
City:
Zip: Phone:
up: Phone:
i certify that no .pork or installation Inas commenced prior to time issuance of a perrrmit-
St_ Lucie Countv makes no representation that is granting a permit rill authorize the permit holder to build the subject structure
which is in conflict with any applicable Noma Owners Association rules, byla,.vs or ano covenants that may restrict or prohibit such
structure- Please consult vvith your Home -,owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, 1 do hereby agree that 1 :vill, in all respects, perform the vxrk
in accordance v ith the approved pians, the Florida Building Codes and St. Luce County Amendments.
The following building permit it 2pplic2t'nns are exemptfrom undergoing a ill concurrency review: room additions,
accessory structures, stitrimming pools, fences, :va.ls, signsscreen rooms and accessoR, 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 jobsite
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 of Ownerj-essee,'Contractor as Agent for O:uner
Signature of Contrac-,orILicense Holder
iI
STATE OF FLORIDA 1
STATE OF FLORIDA ;
COUNTY OF ; ' _ _ _ I
COUNTY OF
The forgoing instrument :vas acknowledged before me �
The forgoing instrument was acknowledged before me I
this day of T / y 20 /9bvI
. 1
1
this /,S day of 1Tu�i1 , 20 by
(Name of person ackr•.oerledging j
(Name of person acknov,Iedging )
(Signature of Notary Public- Stat_ c:.. a) i
(Signature of Notary Public- State of Floriica=j
Personally Known OR Produced Identification
Personally Kro.vn OR Produced identification
Type of Identification Produced
Type of Identification Produced
Commission No_ CHRISTINE BE] dttftmission
No.
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REVIEWS FRONT ZONING SUPERVISOR I
PLANS 'VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW i REVIEW I
REVIEW REVIEW REVIEW RFV1EW'
DATE
COMPLETE
_
INITIALS
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