HomeMy WebLinkAboutbuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number;
COUNTY
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
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Address: t5 R RNc— p kueck 339ft9
Legal Description: \j-Q \1j rtU IjQJ2L £ty415 '.E*O\ \ 4
Property Tax ID 4; -k'è3 93S &3? 01L'h (4D Lot No.
Site Plan Name: (3 UJLYr\ Block No.
Project Name; CT5(
Setbacks Front Front Back: Right Side; Left Side:
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Total Sq. Ft of Construction: S. Ft. of First Floor;
Cost of Construction; $ Utilities Sewer [1 Septic Building Height;
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Name ft Name: 5'kfl'WA\ &3-( C
Address;3fl1 'j\KUY..\ tUOS Company; OJoot LAc
City: 0'jQ.p '3 " State: t-( Address: \3%Zfl V\u. '-& %4
Zip Code: 33'\R1 Fax; City: State;C-&
Phone No. Ca--'a& R.cO3 Zip Code: 633 Fax:
E-Mail; Phone No. C45l)—) tQ... 5St1}4
Fill in fee simple Title Holder on next page (if different E-Mail: ). (7)52fl b-
from the Owner listed above) State or County License; G\-cns-3 9a_
If value of construction is $2500 or more, a RECORDED Notice of commencement is required.
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DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: — Not Applicable
Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: — Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Yfir failure to Record a Notice of Commencement may r'sult in your paying twice for
improvements to your • .perty. A Notice of Commencement must be recor,ed and posted on the jobsite
before the first ins p: an. If you intend to obtain financing, consult with der or an attorney before
commej0.,j.cording your Notice of Commencemen/09,
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Signatu n;?' Lessee/Contractor as Agent for Owner Signatur' of C . . or/License Holder
OF
STATE
.FELQ($z STATE OFFLORlOA
COUNTY COUNTY OF ~f
710J
The forgoing instr me
this &- day of £LfEIai'
t as acknowledged efore me
20 iby
The forgoing instrum nt as acknowledged before me
this day of(2t4S2/" , 20 /Y by
5*n Poar
(Nam of erson ackno - :ng)
t/nAW(A' 14 ' 1
(Name of ps son acknowled,.-;
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Ae4caic4 ,/J,..fl,
Signature 4rYary Public- State of F - gnature of "i Pub - tate of Florida) S
ersonally Know i iijn Personally Known OR Produced Id-,
Type of Iden . . e1* Type of Identifi . S
Commission No. "-%iP' (Seal)
%,4 nha '
Commission No
Commissn# FF935427
November (00019
V
E nyu Tray Pa iniwra -
Revised 07/15/2014
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS