HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO Ml1ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
dU'� Permit Number:
s.
Plonningand DeveloprnentSerulces BUIlding Permit Applic-ation
911114119 and Code Regulatlon Division
2300 Vlrglnla Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Cbmmecclaf
PFRMITAPI PLIICATION FOR: To ---- Rbsidentlal
Select from dropbox, click here _
pROI L. SED�� N ROVEM� INT �ocATlol . f
Address:
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Legal cescription:_e r(._� D ��In,i`C�� l~ � ��.�.• � _ .
Property Tax id #:
Site Plan Name: Lot No,
Project Name: Block No,
••— c+13i�� Back: -
-- —�.� Right Side: Left Sider
DETAILED�QfSCRIPTION OFWQ:KK.
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CONSTRUCON #NFQRMATION
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on a wor o ...,,. orme un er..........
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OHVAC � Gas Tank aPP Y
Gas Piping � �
Electric QS Plumbing �"`� Shutters Windows/Doers
i-.�JSprinkiers Generator (�
Total St{. Ft of Construction. 1:1�l Roof
Cost of construction: $ i 3 Z4 Sq. Ft. of First Floor:
iltilities:Sewer 7septIc Building Height:, _
Name CONTRACTOR
Address, i�,L, Name: dn/
City; i Company: ti(10 � _77) i( ��,iC
ZIP Code: �j� r State: / . Address., i��c? I`ll �i�e�
-�� r? i___ fax: /� i ��,��r5�'
Phone No. 7 - r Cfty: % y i Lure
E-Mail: � � � Zi Co State: F:e-
P de:.3 -e--_ _ Fax: ',77.?
Fill in fee simple Title Holder an next page { if different Phone No, %7„7�._ e 7e- ,�/a.�
frorn the Owner listed above) E-Mail.
State or County L� tense: [' � .l f2 G`�,f�. ���,1 i�sG
14 value of canstructl4ri is $2500 8r mare, a RECORDED �fotica of Comme � ! � II - -
nctrntnt is req�rired, ' �I
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MORTGAGE COMPANY: Not Applicable
DESIGNERIENGINEER: ._NotApplicable
Name:
Name:
Address`— --
Address:
.
City:
State:
City:
'State:
Zip: Phone:
Zip:
Phone:
FEE SIMPLE TITLEHOLDER: ........Not
Applicable
BONDING COMPANY: NotApplicable
Name:
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 malt 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 Homeowners Association and review your deed for any restrict€ons 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;beforq;hp first ins ectian, if you intend to obtain financing, consuie-or attorney before
co enci oi- records cur Notice of Cornmencem�i
_Sigriature'of:Owner/ Lessee/Agent
STATE OF FLORI A K
COUNTY OF E
The forgoing instrument�u s acknowledged before .e ,2 -S
this �E day of (�. !�l .20 2-C-by .
- 4
(Name j person acknowledging) A .4
ature of Notary Public -
Personally Known L1�01; Produced Identification
Type of ldentification Produced
Commission No.�. 1� (Seal)
Revised 07/15/2014
STATE OF FL
COUNTY OF ,_e
U �,
The forg Ing instrument was acknowledged before m
th€s�ay of { 20 ' c b
BeY
,c+ o Lo
ON) mg rv4 a
aw
(Name of rson acknowledging j
�
f
(gnature of N tary Public- State of Florida)
Personally Known L./'Ofi Produced Identification
Type of Identification Produced
Commission No. % (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS