HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPlETED FOR APPLICATION TO BE ACCEPTED
Date: .;vjJJt ! ~ Permit Number: ______ _
COUNTY °""'
I J_ O R ! D n,
Building Permit Application
Planning and Development services
8/Ji/ding 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
· t!RA~tft~fffmtA~;r ?'1 . , •.•..
Address:_ l 11fl -nrYl/1'<:c •
1 5
Legal Description: 6Dldeo Vmds Mobil.e. Homo. Tutt.,
Property Tax ID#: l-30~ --1-L, ,o oi-s-ooo 15 Lot No. ___ _
Site Plan Name: ______________________ _ Block No. __ _
Project Name: _____________________________ _
Setbacks Front ____ Back: ___ Right Side: ___ Left Side: __ _
,s permit-c
Gas Tank as Piping
D Plumbing Osprinlders
Shutters
□Generator
0 Windows/Doors
□Roof
Total Sq. Ft of Construction· ______ _
Cost of Construction: $ i\-0157) JJO
S,. j of First Floor:
Utilities: Sewer O Septic Building Height: ___ _
Name----4.LLl..!..!;L¥.lM~.!W-I/II..I!'!,-':-~"---'==µ~.!....
Address:~'l,li-'--""-"'~/L-..L.::.:..s<'---------
City: ~/M'\O State: Ft,,
Zip Code: fflta'I Fax:
Phone No.f~; D,wjd_ V·-,¼P\--jC--,V'-~--
E-Mail: ~IQ•Lf[/p•~
Fill in fee simple T"ll:le Holder on next page I if dlffet ent
from the Owner listed above) ..
Name: ~~~a._,~~~~-----:-.,.,---:-,---=c-
Company:
Address:5~(~02.l!ft:....M!'.!'W!Kb.J:t.j~Cf~---=.-
City: fofb K'e,rce,, State: R...
ZipCode: ·3J./-I.ISJ Fax:11:Z..·L{/;h-37?.,,
Phone No.17:J.-%(-414::1
E-Man:baYlwe,ll vahoo. co/\'.)
State o:COCnty Licenk eAc 1111-SI "! (p
If value of c:onstruction Is $2500 or more, a RECORDED -of Commencement Is required.
SUPPlEMBfTAL CONSTRUCTION UEN lAW INFORMATION:
_ Not Applicable MORTGAGE CDMPANY: _Not Applicable Name:. _______________ _ Name:. _______________ _
Address:. ______________ _
City: __________ State:_. _
ap: _____ Phone,_ __ ~------
Address: ______________ _
City: ___ ___,,--------'State:
Zip: ____ Phone:. ________ _
FEE SIMPLE Till£ HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
·Name:'-----------------
Name:. ________________ _
Address:'--------------
Address: _____________ _
Crty:'-----~----------ap: _____ Phone:. ________ _ City:'---------------Zip: _____ Phone:. __________ _
OWNER/ CONIRACIORAFRDVO": Appllcatiu,, is herebJmade1D obtain a iamitto do theworkanrt mstaUatirJn"" indicated.
I certify that no warlc.,, i>IStaH;mor, MS Uklhil&k.EI! ,.;or tD the issuance of a permit.
St. Lucie Count!( makes nu lejJI ililtlun that is~ aJM!!iDitwiU authorize the pennithaiderto build the~ structure
• which is in mnlktwilh at1¥M• ahle •lomeOwiiers .~ssv mg,~ bylaws or and covenants that mav restrict orPf'!)hibitsucll
structure. Please consultmt,,...,--your Home Owners AssoriatioP 'VIII review your deed fur any 1eSbictious which may apply.
In consideratlon of h, pantilifl .if this requested permit, I do hell!by agree that I will, in al respects.. perform the work
in dWlldaiite with the approved plans. the flo1ida lluilding0lde5and St. l.ucie County Amendments.
The following building permit applications are exempt from undelgoi11g a full coocurrency review: room additions,
aa:essmy structure,, swilmllilifl pools, fences, walls, signs. saeen rooms 3l'd accessory uses to anatbet non-residential use
WARNING TO OWNER: Your failure to Realid a Notice of Commencement may result in yow payingtwic:.e for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobstte
before the first inspection. If you intend to obtain financing. consult with lender or an attorney before
commencirur work or. -. Notice of Commencement.
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Signature ~ Agent~ Signature of Confractor/Ucense Hokier
STATE OF FLORIDA 8,l.w}l-SFATE OF R.ORIDA St-Luae.,
COUNTYOF COUNTYOF
Them:~wasadcnowl lgelh.?fi:Jreme
I
The forgoing~ admowledged before me
this day of ~1, . 202-1 by this2!1:!l,.dayof .20..2:!_ by
Micha.el F. B>v~ "-~-:~ll~-Nameof~slatmnent
Pemmally Known OR Produa!d ldeidifii:ation __ Personally Known~ Pmdua!d ldentifk:ation
Type of Identification Type of ldeutif.catio,1
Produced Produced
~~f!:::': LJ.A,i,4~ I Uniw,u,0 -..
(Signature of .
~ CHRISTINE JOYCE CONWELL
Commission No. ••• •:•;iy'j,;;;-: •. ,, CHRISTINE J~NWELL commission ..... 'f,.~ ,...,.;\ Notary Public· Stat~ffmd•
f :C-{~·_. \ Not1ry Public • State of F lorld1 , ~il-l _,..,. .... tss1on # GG -1 1 \i V/ Commission# GG 98.f101 ·~o,r,; .. / My Comm. ExplrtJAUI 21, 20H
··-..... ,~~--/ My Comm, E.xplr-sAu121, 202~ .. ,, ... , 'Bonded through National Notary Assn.
con(ltc 1nrou1n Natwnll "' ary ,mn,
REVIEWS -nun• Pl.ANS VEGETATION SEATUKTlE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17 -