HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC BLE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'i Permit Number:
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Building Permit Applicati n 6�one
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 line
�P�ROP®S`ED IMPROUEMENT LOCATIC�3lV`' � pt ` �. �.
Address: %3 D j' d'/� �c�` /,�w� ��a. SY9-r— 7
Legal Description: f�/�h �C S' �;26/v _ Z/V
Property Tax ID#: � �a '' d�'1 I9d "C-,o Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front I Back: Right Side- eft Side:
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CONSTRLICI°CON I'N:h®.ItIall
VIATLON,:
Additional work to be performed under this permit—cFe—ck all apply:
11HVAC Gas Tank Gas Piping _Shutters ,❑Windows/Doors
V Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sci..Ft,of Construction: S . Ft.of First Floor:
Cost'of Construction:$ (� Utilities: SewerSeptic Building Height:
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INNER/ E-SS E C®:NTRA T®R: IN N
Name j495<1P4 <^ �`/�`� / Name: 131fa C Al 4UJO
Address: /30 3 Vie -,'AJ Company:
City: is C.c.0t State: f�u Address:�fOSA/l(d/? Nte I b 6L��
Zip Code: Fax: City:�P_rL_ Stater
Phone No. � 2 �� ���" 3`7 � Zip Code: ,�5/9 0 _ Fax:?7 -6-AL
E-Mail: . Phone No. -7./ qro
Fill in fee simple Title Holder on next page(if different E-Mail: L,5'L a a A ' 6 o' lA
from the Owner listed above) State or County License: C�Gr C D,q,�'P
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SEIVI"AL C®NSTRCTN. LIEN LAW INF®FtM "
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:A, Not Applicable z
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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.
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Signature o wner/Lessee/-ContractorMstggent for Owner Signature of ontractor/License Holder
STATE OF FLORIDA / l _ STATE OF COUNTY OF_ORIDA S-- '—Z �
COUNTY OF IS _
The for o ng instr nt Jya acknowledg before me The f i instru t wa cknowledge fore me
this ay of \ 20�by this�y of 20 by
(Na p rson acknowledging) (Name of erson acknowledging)
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(Sign ture-of-No blic-State of Florida ) -Signatur o a Public-State of Florida )
Pers ally-, a duc ALelatitictition Personally Known OR Produced Identification
n rockltIF&A M HUFF a of Ide o P oduced
;a*. Rc Notary Public-State of Florida ��tPRrp,,,
Com isNo I•_ Commission#FF 2347(3, al) Commission, ANGELA M H
rF`�P;` My Comm.Expires May 27,20,9, ,� °arY Public Stare EE
` Bondedthrough National NM.vv Ass-, "ss, °��c Commiss' or Florid
Bondedomm.Expires Ma 4d4230
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Revised 07/15/2014 z„ rhrou9nNarionarN1;, ,
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