HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit (Number:
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) 462-1.578
C,D[NA
Commercial I)— Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: ()-C6; lo -We, i
Property Tax ID #: 3 LYS- p It - l Ss_ `000 L Lot No.
Site Plan Name:
Project Marne:
Setbacks Front Back: Right Side:
DETAILED DESCRIPTION OF WORK:
V
Left Side:
Block No.
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name
t
A ij�itlfiona workto e e Orme en er t �s p::1 — check
a app y:
City: State: FL
Zip Code:Fax: 4111
Phone No. C) j
11HVAC E] Gas Tank
City: _ Jam'!%L;1 1���`L-� State: I --
Zip Code: L( ice^ % Fax:�~:- r7 9? 3
Phone No.-_7`/�.� 3q—) l U"
as Piping_
Shutters
Windows Doors
Electric � Plumbing
E$prinklers
En Generator
� Roof Roof pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $
w
Utilities:17
Sewer
[]Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: r '
`Fr -(u, lo- C?
Address: 9L fir) S` , )Ct Ln
Company: —r7LiLC.r
City: State: FL
Zip Code:Fax: 4111
Phone No. C) j
Address: 16)11 tOL
City: _ Jam'!%L;1 1���`L-� State: I --
Zip Code: L( ice^ % Fax:�~:- r7 9? 3
Phone No.-_7`/�.� 3q—) l U"
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail -3ey V i' ,3�!
State or County License: Lz -(Y-1- r' �1, _
a. gall u4& WJJ Eb 4,Z71JV OF inUFt!, d I[ct.t.;nutu moince oY LOmmencement 3s requireci.
SUPPLEMENTAL CONS TRUCTION LIEN LA IN1=ORMATION:.
DESIGNEIQAEnI.IfurcD
•
Dame: of Applicable
Address:
City:
Zip: Phone: State:
FEE SIMPLE TITLE H®LDER.
Name:
Address:
City : _
ZIp: Phone:
MORTGAGE COMPANY:
Name: Not Applicable
Address:
City:
Zip: ^� Phone: State:
Not Applicable BONDING COMPANY-
Name:
OIV! NAP Y;
Name:
Address;
City;
Zip: __ Phone:
Not Applicable
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 a I
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. y PP y
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 m
Improvements to your property. A Notice of Commencement must be r orded and po ted on the jobsite
before the first Inspection. If ou intend to obtain financing, consult lender or- n Your paying twice for
commencin mork or reca uour Notice of Commeneement.� i orney before
of Uwner/Less JContractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF L f .
The forgoing instrument was acknowledged before me
this day
of i 20–bY
(Name of person acknowledging )
(Signat a of Notary Public_ State of Florida )
Personally KnownOR produced Identification
Type of Identification Produced
Commission No.(Seal)3ENNAL.FRANGO
rov PUBc` Commission # GG 323779
�` �xoites Aptti 29, 2023.,..
Revised 07115/2014 N�9T .- got dedTh�
re of Contra
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this KIK day of jG'�C 20 06 by
0 /16119 L-
(Name of person acknowlt_dging l
(Signatu of Notary Public- State of Florida)
Personally Known;:,/— OR Produced Identification
Type of Identification Produced
Commission No.a �� (Seal)
I'��RY.Pvsi,_ JENNAL,FRANCO
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