HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR-APPLICATION TO BE ACCEPTED u
Date: J C ' I 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: Pool inground
',PROPOSEDJIII/IPROVEMENT�LO.CATION `,, f�� �;,`� '_ `4 Y ..�
Address: II l L G� '
Legal Description: a 14 -e
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front � A Back: D I Right Side: 53 Left Side:
DETAILEDrCDfSCRIPTION
...-.i.:>.:.,..< ..:..:.F „.n i7..,.�.,. i-:l.. ...::. ...,.v>.:t .;-•i-1.. .... ..... ....._v..: ... _.i�.t ...�.....,�.'. si,, r.:,i, .:7._•.-t
1`'OO( U.)l+P 1 .
xCONSTRUCTION IN'FOR11/IA°TION w s •� }fs a_ _�__;;
4, k ? .v..t.
Additionalwork to e e orme under this permit-check all apply: _.
❑HVAC Gas Tank Gas Piping _Shutters Windows/Doors
❑Electric 0 Plumbing Sprinklers El Generator 11 Roof
Total Sq. Ft of Constructionn:� S . Ft.of First Floor:
Cost of Construction:$ C7,�Q� Utilities:-Sewer OSeptic Building Height: '
OWNER` LESSEE
r. ; CONTRACT t
Name V �Vk� ' S 11, Name:�- aaw<jT L2-e
Address: - t Company: 6. �aldr c- P001.5
City: a State: Address:L 410 5qp:� &Ve -
Zip Code: "N 4C Fax: City: t'G. pIeedle- State:
Phone No. r,,T3 ? 4 89 Zip Code: ,'Wq$�P- Fax:77,2.4 y7'-Apo-LLk
E-Mail: J ` �S �, �d;Ue-tQJA4 Phone No. 'na-
y
Fill in fee simple Title Holder on next page(if different E-Mail: [ kerf)o./1 • Corn
from the Owner listed above) State or County License: C O
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION L)EN LAW INFQRMATION.
DESIGNER/ENG NEER: Not Applicable MORTGAGE.COMPANY: - _Not Applicable
Name: Name:
Addre s: Address:
City: State:_ L 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:
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
CO ncin W rk or recording our Notice of Commencement.
\ s
_Signature o Owner/Lessee/Agent; Si t of ctor/License Holder
STATE OF FLORIDA ATE OF FLORIDA
COUNTY OF COUNTY OF
The fo going instr ent.wa acknowledged before me The forgoing instrument was acknowledged before me
this?day of 20 Q-by this 2L day of OV1 - 20 6y
k P."
D -�-d
(Na of p s ackno I gingJIN MCferso9,a"owg1dng)
(Signature of Notary Public-State of Florida / (S" nature of,Notary
/P_blic-State of Florida)
Personally Known OR Produced/dentifl tion ✓ . Personally Known M OR Produced I entifi tion
Type of Identification Produced I. Type of Identification Produced
Commission No. ea ommission No. pY P,j'••.,
FA A HEFtNANDE ==o, ®y�,_ FA HoARNANDE
COMMISSION#FF1724t MY COMMISSION#FF172at
Revised 07/15/2014
'EXPIRES October 28,2018 ?1 oF' oP: EXPIRES October 28,2018
' (407)3981153 FlotidallotaryService.com •(407)398-0153 FloridallotaryService.com
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COMPLETE• `
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