HomeMy WebLinkAboutBuilding Permit ApplicationDate,,
Permit Number:
ti I
3MAM L
Planning and Development Services
Building and Code Regulation Uivisiorl
2300 Virginia Avenue, Fort Pierce FL 34982 ResidentialPhone: (772) 462w-1553 Fax: (772), 462-1578 Commercial
PERMIT TYPE:��lC.
NOOO���e��
PROPQSED IMPROVEMENT LOCATIQN:
Address:
Property Tax ID #W 2w(O
Site Plan Name
Project
Lot No -._U__
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: Block No.
_ ___
P WWWWOPPOW
T A F S
V V 0
'DE . . . . . . . . . . . . . . . . . . . . ..... . . . . . .
LE
CONSTRUCTION INFORM
Additional work t
Mechanical
o be performed unde
Gas T'ank
r this permit
ddk
Gas Piping
_Electric Plumbing Spri
Total Sq. Ft of Construction:
Cost of Construction: 2��J
OWNERJLESSEE
i L
Name
Address.
City:
nklers
rd�
11 that apply:
Shutters
Generator
Sq. Ft. of First Floor-.
Utilities: Sewer
CONTRACTOR:
ame:�%pC
o pany:''fi�
State:(Address::3�>2
city:�1
Zip Code.
Phone No
E -Mail:
Fill in fee simple Title Holder on next page (if different
�I from the Owner listed above)
it vaiue o
If value o
d4P
Zip Code: 4
Phone No
E -Mail
State or
Septic
o
f Pitch
Fax. 32 1-
Dr Z5
t
State:
County License
, %.ons'truction is $2500 or more, a RECORDED Notice of Commencemen
f HVAC is $7,500 or more, a RECORDED Notice of Commencement is r
t is required.
�uired.
DESIGNER/ENGINEER:
Name:Address,
4 1caltyl State0zi Phone
FEE SIMPLE TITLE HOLDER, Not Applicable
14Name,Address:
CpyZIPlow Phone&
.1Name.
k 7 *
•
icy
Not ApplicableState:
NotApplicabir
theworkandinstallationas indicated.ar0`1111esujectstructutsthatmayrestrictorprohibitstrictions whichmayapply.
pects,performthework
room additions,
anothernon-resident*iaiu-se
ULTINYOURPAYINGMUSTBERECORDEE OBTAINFINANCING, CONSULT
Ct-)0Woreme
2by
ORProIicaion
atoda0tate ofNot,ry Put)','GG 308050C0rTISSIIDal). txPiresmaronai NotarySEATURTLE MANGROVEREVIEWREViE\& -----
a
Addressi.
a
citym
Zip: Phone:
A
BONDING COMPANY,
0
Name.
Address.
City:
Zip: Phone:
OWNERCONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do
I
certify that no work or installation has commenced prior to the issuance of a permit.
N permit holder St. Lucie Count makes no re-resentation that is granting a ermit will authoriz h 11" (a dh P structure
which is in conflict with any applicaUle Horne Owners As'sociation rules, bylaws or an ' covenan uch
structure, Please con -suit wit Iiyour Home Owners Association and review your deed for any re
h) consideration of the granting of this requested permit, I do hereby agree that I will, in all res
m accordance with the approved plans, the Florida Building Codes and St. Lucre County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: rgoing
accessory structures, Swimming pools, fences, walls, signs, s
Green rooms and accessory uses to
ab ARNING TO OWNER.' YOUR FAILURE TO RECORD A NOTICE-
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENTAND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of lOwn'e
STATE OF FCC
COUNTY,
R
!Contractor as Agent for Owner
T e ing instrument was acknowle ae efore m
thi5V d a y o by__
Name of person']
aking statement,
Personally Known OR Produced Identification
Type of Identification
Produced
0
1
-711 SOR
REVIEW
9
STATE OF FLORI
COUNTY OF I
The �g�ing instrument w
r%^ �+ __,
this ��day of 1 1 1
Name of person making statement.
Personally Known `�
Type of Identification
Produced ,.
ft
I^ Iff
{Signature of N.. y Public-�4� "�re Flo�da
Commission No. 5.2023
Assn.
PLANS VEGETATION
REVIEW REVIEW