HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENIALC:ONSIRUC iION LIEN LAW iNFORMAIIUN:
DESIGNER/ENGINEER: Not Applicable
! MORTGAGE COMPANY: Not
Name:
— Applicable
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:
Cit}�
Zip: Phone:
Zip: Phone:
i certify that no 'work or installation 11as commenced prior to the issuance of a permit_
St. Lucie County makes no representation that is granting a permitr:ill authorize the permit holder to build the subject structure
1.hich is in conflict with any applicable home Owners Association rules, bvlarrs or ana covenants that may restrict or prohibit such
structure- Please consult :-Ah your Home Owners Association and reti iery your deed for any restrictions -which may apply.
In consideration aT the granting of this requested permit, I do hereby agree that I :will, in all respects, perform tie c-:ork
in accordance e, ith the approved plans, the Florida Building Codes and St- Lude County Amendments.
The follor!ing building permit appGcat_ons are exen.ptfrom undergoing a full concurrency review: room additions,
accessory structures, swimming pool, fences, «a=1s, signc-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 {saying 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 or Commencement.
Signature of Ower/�essee}Contractor as Agent f or O:vner
Sio ature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
-- —
COUNTY OF
I
The forgoing instrument :las acknowledged before me
The forgoing instrument was acknowledged before n,e t
this day of 20 19 by. i
this !a dad of 69—� 20 by
�
_ f
(Name of person ackrc. pledging )
(Name of person acknot_ledging j
(Signature of Notary ?ublic- Star . , = - : is )' i)i
i
(Signature of Notary Public -State of
-
Personaliy Known OR Produced Identification
Personally Knovvn OR Produced identification
Type of Identiftation Produced 1
Type of Identification Produced
Commission No-'ri _ - 29g ° CfiRlSiiNEBENCM�mission
t y MYC04!M?SSlON3�G052�a46
tT�� put CY.RS..K: rrli
No. _ - -� 4�
EXPIRES-Ap it
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EXPIRES: Apru4,n21
REVIE NS
i -
FRONT ZONING SUPERVISOR PLANS ` VEGETATION
--Sex.i
SEA TURTLE
iviANGROVE I
COUNTER REVIE°N REVIEW REVfIEW REVIEWRE1/tELb'
sEV1E11�`
DATE
E
COMPLETE
INITIALS ___
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ew / Permit Number:
� ,
ounuing rermn: Applicavon
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 I ION FOR: To Select from dropbox, click arrow at the end of line
PRUPUSEU IMPROVEMEN I LUCAI ION:
Address: s/63 /y f7iQ%Ilt%Qy L4 I J
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name: _
Setbacks Front
Back: Right Side: Left Side:
Dlz I AILEU L)ESCKIP I ION OF WORK:
Lot No.
Block No.
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e
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CONSTRUCTION INFORMATION:
Additio wor o �e ner n-e-d under Phis perms# =checkaTT app-iy:
HVAC Gas Tank ]Gas Piping Shutters F] Windows/Doors
Electric U Plumbing Sprinklers Generator L1 Roof l--J Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ n
OWNER/LESSEE:
Sq. Ft. of First Floor: —
Utilities: 01 Sewer 0 Septic
CONTRACTOR:
Address: s� La e,satirl� -
City: State:77V
Zip Code:Pkov-%3/`
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
Name: C'U(L'ffS iJFlL11cr'►
Company: Cat :�-TC nt A \ r_ u c t el'&'s ( fu c,
Address: 14715
City: Po 2T St - L u c i State: �t-
o�-
Zip Code: �t ,� 1- Fax: r?
Phone No. / -1 a 3 3 5- 3 .l
E-Mail: C u S t& t r s Ck c
State or County License: C A C o 5 l E 10
if value of construction is $250o or more, a RECORDED Notice of Commencement is required.