HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04 � o2 D 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) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: 97 � I pc 11v PS L, FL 3 g q gt) _
Legal Description: _ I Ong_ 3 A k 1-.e y- y-e t4 a� %j l �� S
Property Tax 1D #: Lot No.
Site Plan Name: '` Block No.
Project Name: 51 K0 t`
Setbacks Front Back. Right Side. Left Side:
Aacutional work to be pertormed under this permit — check all that Sappy:
`Mechanical _ Gas Tank _ Gas Piping /V Shutters
Electric ` Plumbing _ Sprinklers / = Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $�_7� Utilities: _ Sewer _ Septic
Windows/Doors
Roof Pitch
Building Height: 30
Name DQ'C6 -k V S i k6 r o, Name: �}
Address: 61 8cfly Au o n Company: C2,!;6_r
City: — (PS L_.._ _ State: k— Address: Z 1
Zip Code: 3_1j Fax: City_ t L'r State:
Phone No. S --S%S Zip Code: 9 Fax: 122- c16 /- d&s sE
E-Mail: ti A Phone No .7
Fill in fee simple Titl He o der on next page ( if different E-Mail 7b0v?,_ S� 1 L tiz,
from the Owner listed above) State or County License d'C61.311' SD�
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required
DESIGNER/ENGINEER:
Name:
_ Not Applicable MORTGAGE COMPANY: Not Applicable
Address:
Name:
Address:
City:
Zip: Phone
State: City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable BONDING COMPANY: Not Applicable
Name:
Address:
Name:
City:
Address:
Zip: Phone:
City:
Zip: Phone:
OWNIFR/ rnluTuer•Tno ACEIrn.n-r. r
-- - w •—• --• • • •—.I I . MfJP11cdLlon is nereoy mace to obtain a permit to do the work and installation as indicated.
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 apply.
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.
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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
aAgen0/orOwner
G /0z �Signature of O e
er/ Lssee/Contractor as ignature of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA I
COUNTY OF S• Lc {G COUNTY OF_
The far oing instrument w5U acknowledged before me
this dayof__�S_. 2020 by
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Name of person making statement.
Personally Known
OR Produced IdeTO
Type of Identification
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DATE
RECEIVED
DATE
COMPLETED
ev. 8/2/17
The for
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this day of U 202L;' by
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Name of person making statement.
Personally Known OR Produced identification
Type of Identification
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nature of Nota lic of Florida )
Commission No.
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Commission 9 GG 189841
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Bonded through Nati nal Notary Assn.
REVIEW i REVIEW