HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: z
®� Permit Number:
S 'J'_ t.
Planning and Development Services B
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462.1553 Fax: (772) 462-1578
PERMIT TYPE:
L PROPOSED IMPROVEMENT LOCATION
Address: t
Property Tax ID #:
Site Plan Name: _
Project Name:
DETAILED DESCRIPTION
OF
CONSTRUCTION INFORMATION:
ufldmg Permit Application
Commercial _ Residential
Addit� nal work to be performed under this permit –check all that apply:
_Mechanical _ Gas Tank
_Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ y Sq• Ft. of First Floor:
Utilities:_ Sewer _Septic
OWNER/LESSEE:
ruuress: ( Ci7hi.0
City: � � c h ICS (`T
Zip Code: <' ggjg� Stater
Fax:
Phone No.
E -Mail: J
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Lot No.
Block No.
_ Windows/Doors
_ Roof . Pitch
Building Height:
Company: 11 1
r
Address: Q)�
�
City:
Zip Code: ',� State: _:EL) G—S� Fax:
Phone No 1 17 � – 7 _
State or County
Vdlue or construction is $2500 or more, a RECORDED N1tice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION
ESIGNER/ENGINEER: LIEN LAW INFORMATION:
D
Name: _ Not Applicable
Address:
City:
Zip' Phone State:
FEE SIMPLE TITLE HOLDER:
Name: _ Not Applicable
Address:
City:
Zip' -_ Phone:
MORTGAGECOMPANY:
Name: _ Not Applicable
Address:
City:
Zip' - Phone: State:
BONDING COMPANY:
Name: Not Applicable
Address:
OWNER/ CONT Zip' Phone:
I certify RACTOR AFFIDVIT: Application is hereby made to obtain a
St, Lucie Counttyy commenced prior to the issuance of a permit to do the work and installation as indicated.
which is in conflimakes no representation that is grantinga Permit.
ct
any
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may a
with ran applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
permit will authorize the ermit holder to build the subject structure
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
V PPIy.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming Amendments.
pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: YOUR FAILURE TO RECORD
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
POSTED ON THE JOB SITE BEFORE THE F TA NOTICE
IF Y
WITH YOUR A NOTICE OF COMMENCEMENT MUST BE RM
LENDER OR AN ATTORNEY BEFORE REC
g�gature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF S -r LLLC i E
The forgoing instrument was acknowledged before me
this 18— day of _ T 1 f} y
T— 26� bV
ljEA C_
Name of person making statement.
Personally Known
Type of Identification OR Produced Identification
Produced
ypsN::°; CYNTHIAMURPHINS
Si ature'o ���onIfGG924772
oto Public -S ASrid res o r 7,2o2g
orrio
Commissio o.
� (Seal)
OU INTEND TO OBTAIN FINANCING RDED AND
ORDING YOUR 11p7ICE OF co CONSULT
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OFA 1 t CIr
The forgoing instrument was acknowledged before
this j� day of q,�
20�00 by me
Name of person making statement.
Personally Known _�
OR Produced Identification
Type of Identification
Produced
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COUNTER REVIEW SUPERVISOR PLANS VEGETATION
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CEIVFD REVIEW l REVIEW
CYNTHIAMURPHINS
Commission k GG 924772
(Seal)
SEA TURTLE I MANGROVE
REVIEW REVIEW