HomeMy WebLinkAboutBuilding permit appALL 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) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of Tine
PROPOSED IMPROVEMENT LOCATION:
Address: 3 aneM0-
f� 11�,2,P`C� 3U�i51
Legal Description: �! a ffl UcK C 5 l �U hJ r12\
I I_
uXJ
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Ufte �Or Lilo; TtiisfitctL 3.5 -fo✓, 14 Seep, Ate,
�otIcaw- UAIt- IA W Wk 10 r-U)
CONSTRUCTION INFORMATION:
iti a wor to a ne orme un ert ispermit —c ec a appy:
_ HVAC 0 Gas Tank [:]Gas Piping Shutters F] Windows/Doors
11 Electric 0 Plumbing L _JSprinklers 1:1 Generator 0 Roof
Total Sq. Ft of Construction: SgFtj of First Floor:
Cost of Construction: $ koo. oo Utilities: 0Sewer E]Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name 4tVillAt.
1 61101
S
Name:
Address: 3
�1iO(ri1 Y10 fN10� W
Company: 1 n"� Hr1 �.
City: tb PIfftt, State: Ilr
Zip Code: 3 4A S I Fax:
Phone No. na'L4Ii) (p$i-(
Address3fo A-R_ l�dcu. fi,,J 82,
City: fbnb— (7f efc& State: k_
Zip Code: "3+q51 Fax:?7.-4& - 3i
Phone No.-"�-- 14AI -4111
E-Mail:
Fill in fee simple Title Holder on next page (if different
E-MaiI:kA\1I ny n & VAMO. Olt) (11
State or County Licen�Se: P.AC I$ I I $ (D
i from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
`�s
Narne: game:
Address: Address -
City: State: _ City: State,
Zip: Phone Zip: Phone:
,, i a * '--aVTITT TIM.e' ➢ f a. iaa
Address: Address_
City: City:
Zip- Phone: Zip:Phone-
i certHy that no work. or installation has mmmencea prior to trse issuance or a permu.
St- Lucie COrar makes no representation that is granting a pry xaiil authoree the permit €older build the sub
wlaidt is is cat wins anyarsplicable Home GrustersAs:,aiiirn rules, bylaws or arm covenants t:`r3t may restrict s
structure_ Please consult: vAh yaw: Hoene Owners Association and review your depd far any t'esuictiorsa€ ich may
in consideration of the granting of this requested permii,I do hereby agree that I will, in ad respects, perform the work
in accordance with theapproved Plays, the Ronda Eliffiding Codes and St- Lucie County Amendments.
The following budding permit application are exempt from underuoang a full concurrency review: room additions,
accessory structures, swimming pool's, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNit4G To `yiww ta&we ties Record a Nistka of €rsft reSL4t tat yo" PaviRg tw ke fOr
improvements to your property. A Notice all Commencement must be recorded and posted On the jobsite
before the first inspection. If you intents to € btain financing, consult With lender or an attomey before
.:...:a. wt.a.-..�aiea� am alraiirc sa£ i'T�mTiRr3t'PSYtRrR�'
STanature of Contnaciodlicense Holier
Signature or Owned LesseellContract=or zi; ea fur
STATE OF FLORIDA
STAn OF FLORIDA
Comm- l�� Sfi luere� �
COUfmilir
The rgnri ins rlentlatas adnowledged before me
by
Tire �1ng instrument was adatoWedged before me
this day of sZDr• .24 by III
tnisda o€- .2ft2o
Dame of persorseekkigstIlitement
Name of pe sea nt
Personally Kncswn OR Produced Identification
PersonallyKoown f R Produced motion
Type of identification
Type of identification
Produced
Produced
(Stgnatureof N
Ngnabarecif Notary State of Ronda )
"•::,. CHRISTINE JOYGF�LI
COmrril55iOn N '. .. Notary Oublic •Stu rids
Commission N .. CHRIBTINE JOYCE C(fY
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Commission # GO 98470E
IMFCommission
an` My Comm. Ex Tres Aug1, 2024
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Banded
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National Notary
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REVIEWS FRONT
SUPERVISOR
' PLANS
VE€OARON
&ROUE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
R€VIEW!
REVIEW
DATE
RECEIVED
DATE
COMPLETE
Rev. 8I2/37