HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982 /
Phone: (772) 462-1555 Fax. (772) 462-1578 C'Ommercia( Resldentlai
PERMIT APPLICATION FOR: To Select from dropbox, click here Wa-v- z, 4-&k c
PftOPOSIrI7`INPROVEMtENT LOCAT);DN: ti : t�nrsx .
Address: a G '.-z l`-!l cuk
Legal Description;
Property Tax ID #: 3 (� o r Lot No.
Site Plan Name, Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side.
DE1;;41LEDfkSCRIPTION OF WdRK '. " C% ci'((6 lv c1--Y i G
G r�--
-777
CONSTRU.C7dNri'fORMATION::'.
Mona wor o e Ee orme un ert sperm - c ec a app y: �� I ,-�
11 L,IHVAC Gas Tank "Gas Piping U Shutters Windows/Doors
Electric Plumbing Elprinklers Generator
Roof
Total Sr{. Ft of Construction:
S Ft, of First Floor:
Cost of Construction,. $ utliities:Sewer Se
PtBuilding Height:
Name l—i�S "io ..iv.►�
Address: 1 ,�
City: L1' [ I�Z 5tat7. FL
Zip Code: 23Fax:
Rhone No.
E-Mail:_
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
�`E:ItAC;10R;
Name: Qe,1 M
Company: ti(l f F lG<I!• �, C 'V- C'ca+i
Address: SG` Aeo fA) . j X pR 1SE" I��e labCity,
Zip Codes 43��' ------State; F�•
FOX'. 776? CitFi�,6
Phone No. 77�-
E-Mail. V ,
State or County Lice i� r
If value of construction Is $2500 or more,;? RECOROIO Natice Of Commence
men# is required.
pESiGfftmf
Name:
Address: state'.
city: phone.
Zap:
1FEE SIMP LE TITLE HOLDER: _,r Not Applicable
Name:
Address: ;
City:
` zip: Phone:
---------------
ot Ailcabie '
NpP
MoR rGAGE,COMPANY:
._--
Name:
Address:
State:
city. phone•
Zip:
,..,_�-�
Applicable
Not ApP
BONDING COMPANY.
Name:
Address:
city: Phone:
Zip:
ermlt,
I certify that no work or installation has commenced prior toerrnit wlilissuance
utharal a the ermit hold er to build the subject s ructbre
e Horne Owners Association rules,�yiaws d ree r eny rae5trldons which mayappl .- such
St Luc a County mak no representation that is $ranting a p
which �s in a ict wit s any appiica i
structure. p ease consult with your Home owners Association and ravlew your perform the work
in accordance
consideration wof ith
approved f this plans, the Florida Building Codes aI do nd St. Lucie Coulnty Amendll, In all mentcts,
in accordance with the approved p
ThQ following building permitapplicationsgopools,
fences wells, signs, creen rooms and accessory uses toeanother non-rles dentlai use
accessory structures, swimming pools, f
WARNING TO OWNER. your failure to Record a Noticeof CtlCommencementmust
be May
toed and result in our p yon�thel jobsite
improvements to your property. A Notice of Comm attorney before
1._N___+" f4rat lncnA&Inn. if you Intend to obtain financing, consu
°S#griature of't3Wnerl LesseeJAgent o S' ""•
STATE OF FL4 I A °1
C t
COUNTY OF
The for ing Instrument was acknowledged before rr
this .� ay of by Ig .L
SH
fivamepfpersonacknowied.4 j
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
Revised 07/ 15/2014
STATE OF FLORID,
COUNTY OFi tm;
The forgot pg instru ent was acknowledged before m n,,, p �
this r1ay of 20 L . isy }
Personally Known Lw-�R Produced identification
Type of identification Produced
Commission No, r �� � '"/ (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
COMPLETE
INITIALS