HomeMy WebLinkAboutbuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date;
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regtulatlon Division
2300 Vlrginta Avenge, Fort Plerce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CbCY merciaE
R6sidentiaE - v'
PERMIT APPLICATION FOR: To Select from dro box, click here
P
PROP, ROV IViE°NT:LOCATION.
Address, rVL t-s f S�
o
Legal Description: __R
rr
Property Tax la #: -33 Cs "� -_ v� r�
Site Plan Name: Lot No. 3
Project Name: Block No,
Setbacks Front____. Back: ---_Right Side:
Left Side•
ut i AIL&I3so'PCR1PT10N OF WORK-, .
Pa�-z; _.
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CNSTRUC1V1bN -IN,FORMATfON:
ffe(,B�me
one war un er s perm -c
ec
HVFC a
Electric Gas Piping a Shutters ers Windows/DoorsZ-uming :jSPrInklers �! Generator � Roof
Total Sq. Ft of Constructlon; 5 Ft. of First Floor:cost of Construction: � � � � �
C�
Utilities: Lj Sewer �SeptEc Building Height:
a1lUNFR/LESSEE;: _ ._ -
Nam
Ics
City:
State:
Zip Code: Fax:
Phone No. .-
E-Mail: . x�
Fill in fee simple Title Haider on next page ( If different
from the Owner listed above)
If value of construction is $2500 or more, a
Name: of,/
Company: tilts 6,4� peeel-f-9101f
Address: .6-0 A1.3
City:711097 g,Lc�e�i state: Fi
Zip Code; Fax; 17a
Phone No. 77,1- 1?781-•
E-mail.
State or County License: C
Notice of Cflmmeneement is required,
Name:
Address,
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _.:__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:
l certify that no work or Installation has commenced prior to the issuance of a permit,
st Lucie County mak�s no representation that is granting a permit will authorize the permit holder to build the subjects ruct'ure
which Is In conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or pro�Iblt 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 ail 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, wails, 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 first ins ectian, If you intend to obtain financing, consu-lemderQ4 attorney before
co -__encll r c or recor I >�ur Notice of CDmmencem !
�:_•°Signature"of owner/ Lessee/Agent m
STATE OF FLO I A 11 Q
COUNTY OF
The for ng Instrument was acicnowiedged h fare -2 e
JS
this May of 20 29y W .1 -2
li r. J a 812
person
Personally Known Lf:�:01; Produced Identification
Type of Identification Produced
Commission No. �f (Seal)
Revised 07/ 15/2014
STATE OF FL O T �3
COUNTY On
The 7for rig instrument was acknowledged b fore mthisday of 6421'l.i 20 y z
Personally Known -I/FOR Produced Identification
Type of Identification Produced
Commission No. _ `7'`t/� tl (Seal)
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