HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST B>: CDMIaLl:TED FOR APPLICATION TO BE ACCEPTED
Date, d.- C i `�G�
. Permit Number:
ti
Building Permit APPlication
Planning and AevelopmentServlces
Building and Code Regulatlon Division
2300 Vlrglnla Avenue, Fort Plerce FL 34982
Phone; (772) 462.3.553 Fax: 772 �62-1578 -
� r �'ornmercial _,__Ri6sidantial
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED IN-I��R-VEM��°NT LOCAT`f .l ! INGI - r -fie �e ram.
Address:
Legal Description:
Property Tax ID q: - �)L4
Site Plan Warne: Lot No, C'
Project Name: Block No,
Setbacks Front----_, Back:
—..-�...` Right side: Left Side;
D£1"AIIwED?pESCR#PT.10N 00 WORK. t LA
TT
:. �IWIX #1 Q.R;IVlATION. - . -----
1]ona wor so a Dime an ert sperm -c ec a
HVAC Gas Tank apP Y
Gas Piping Shutters �'""
Electric Q Windows/Dears
Plumbing :]Sprinklers
Total Sq. Ft of Construction: Generator Roof
Cost of Construction: $ [ 4 3 , O-D S Ft. of First Floor:
Utilities:�SewerZSeptJc Building
N°E;RREl _9_ Height:
0W
Address:
City: Uri
Zip Code; State:.. F�Ll
Fax;
Phone No. - 3
E-Mall:
Fill in fee sintiplIs Title Holder on next page ( if different
from the owner listed above)
value of construction is $2501} ar mare, a
Name-,
Company: k(ro- C�Pi �LtI{• �i C �`
Address:
City: ae.t Der Gf �/�a
i Lc. ,rlr
ZIP Code, 2 �e State: FL
----�- _ Fax: 77a2 -g7% r' &
Phone /i/V�o.f�77���y- y�, ^��/—,.�1
E-Mail,{ `(%!].V/1 dI fU A � A Irl/ i s d
State or County Llcense: �. Z / ,�
D Notice of Commencement is required.
Name:
Address:
City: _ .�: - ..._ State:
Zip: Prone:
PEE SIMPLE TITLE HOLDER: Not Applicable
Name;
Address,
City;
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
!Name:
Address.
City:. State:
Zip: Phone`
BONDING COMPANY: Not Applicable
Name:
Address.
City:
Zip: Phone:
1 certify that no work or installation has commenced prior to the issuance of a permit.
5 L Me Counttyv makes no repress tetfon that Is granting a perrreit will ut adze the permit holder to build the subjects ruciure
w IC is in coni3lct with any applic Ne Home Owners AssocFeet€on rules,aiay aws or and covenants that may restrict or prSl bit 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 1 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: 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 Jh@ first inspe_c�lo�if you intend to obtain financing, consu endePQ4ap_attorney before
;-:SIgriature'of.Owner/ LesseeJAgant
STATE OF FLO l A► ►
COUNTY OF g
The f r o nntg Instr was acknowledged before .
this ay of . 20 ,fly
. l � � tir►►t pr
(Nae O person acknowledA-ing) �
m_.. -.
'(Signature of Notary Public- State of Florida )
Personally Known �OR Produced Identification
Type of identification Produced
Commission No. (Seel)
Revised 07/15/2014
STATE OF FLOR Q
COUNTY OF
The forgoing Instrumqnt imas acknowledged before m
this "4—day of 20 by �e
Personally Known L<�OR Produced identification
'type of identification Produced
Commission No, (Seal)
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