HomeMy WebLinkAboutBuilding Permit ApplicationLAL --
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l 1
Date: Permit Number: O ! F
o -
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
RROPOSED IMPROVEMENT >LO-CATION
Address: G 4 � -7 (a( 1p c-- r CtPL cy LA -
Legal Description: S41aflG `t key r
Property Tax ID #: l 3 Q 6 /—_ t l /-z' o z -acr&d Lot No.
Site' Plan Name: A 61A t`� A -r-, //' S lY' �l�t, Block No.
:Project Name: 4
Setbacks Front Back: Right Side:: Left Side:
i
DETAILED DESCRIPTION OF WORK'
-IY4S fe'- `I `j /4cf en ci6 S
CONSTRUCTION INFORMATION
_ _. s.: _ .
AdditionalworKtotienerformea under this permit - cneCK all ME apply:
❑HVAC ' 0 Gas Tank ❑Gas Piping _ hutters ❑. Windows/Doors
F]Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 1�3 O 6
S Ft. of First Floor: _
Utilities:0 Sewer El Septic
Building Height:
OWNER%LESSEE _CONTRACTOR
a
Name �cf1 bi e. �C 4U
Name: c¢
C
Address: 135 L 6 G ergs i s C2f
Company: 1 r
rIC4^
'Ciity: ��GA State:
Addresses• i?
Zip Code- Fax:
City: /- fi 1 �!�-�i
State:
Phone No. 7 7 :�- 6 %" 4*3 �qg�"
Zip Code:
Fax: % a "" 7�6 ISM
E-Mail:
Phone No.
Fill in fee simple Title Ho der on next page ( if different
E-Mail:
from the Owner listed above)
State or Coun icense:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
aty. - - State:
ZIP:- Phone:
FEE,SIMPLE TITLE HOLDER_: - ' _ Not Applicable
Name• ,
Address:
city.,
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name: -
Address:
CRY.- State:
Zip: _ Phone:
BONDING COMPANY: NotApplicable
Name.
Address: '
-
zip: Phone:
i certify that no work or installation has commenced prior to the issuance of a permit.
St W de Counttyy makes no repr�err�aation that is granting a it �nli authorize the permit holder to bud the subject structure
which is in conflict with a3glicable Home Owners anon rules, bylaws or and covenants that may, restrict or prohibit such
structure. Please consult vthyour Home Owners Association and review your deed for any restrictions which may apply
In consideration of the granting of this requested permit, I do herebµagree that 1 will, in all respects, pertnrm the work
In accordance with the approved plans, the Florida Building Codes and St Lucie County Amendments.
The followinglwllding permit applications are exempt from undergoing a full wncurrency review. room additions,
accessory structures, swimming pools, fences, wails, signs, saeewroom.&and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your -aging 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
STATE OF FLORIDA
COUNTY OF i it
The forgoing instrur_�� adcnawledged�b before me
this day of, .-20
7 .
(Name of person adfld Wedging )
I V
UWftft of Notaryub c S of FI ) 11-4
Personally Known OR Produced ldentfication
Type of identification Produced
Commission No.
MY COMMISSION
—rinto: uecember20, 2022
••'�°F P :°�'' Bonded Thru Notary Public Undenvritars
Revised 07115
STATE OF FLORIDddl `
COUNTYOF '�iL►�' o ,
The rMof meat was acknowledged before me
this f�20_* by
'75701 1, 0 • J
ASK
Personalty Known_ OR Produced Identilic ation
Type of Identficatioptw
s�PYs�i: I.ASHANNA RA
Commission No. *: -I' (YMAANIS LAMING
it
G 27
' of Fcoy . FxPIRzs. December 20, 20220
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