HomeMy WebLinkAboutAPPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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 x
Address: 1 Motrilfi ( r04- Nat R- ?qlqq
Legal Description: l0l011 V t % ac k 81 K 5 L Vn 10
Property Tax ID #: 14-15 lot 0113 000 6 Lot No.��
Site Plan Name: �iig9b 1b - b oul b _ - Block No.
Project Name:
Setbacks Front_ 1,Z Back: X Right Side: x Left Side: X
DETAILED DFSCRIPTIbN Of WORD
REPLACE %I WINDOWS & 3 DOORS WITH IMPACT. SIZE FOR SIZE.
[:JHVAC
11 Electric
L—J Shutters
❑ Plumbing 1:1U Sprinklers 11 Generator 11 Roof Rcof pit&;
Total Sq. Ft of Construction: pp S Ft. of First Floor:
J _
Cost cf Construction: $ I %M- Utilities:[] Sewer Septic
OWNER/LESSEE.
i Name 31WOiSOa
1 address:_ �t5'1 rlGrtillQ�I
City: YOfkyit(:lrfc State:FL
Zip Code: Fax:
q
Phone No. 1r)'A ot fil b
j E-Mail:
FIII In flee simple Title Holder on next page ( If different
from the Owner listed above)
Name:
Company: FHIA LLC
Address: 3044 SW 42ND STREET
City: HOLLYWOOD
Zip Code: 33312 Fax:
Phone No. 954-884-8500
E-Mail: PERMITS@FHIARFMODELING.COM
State or County License: ChLUM0
if value of construction Is S2500 or more, a RECORDED Notice of Commencement is required.
State: FL
i
SUPPLEMIti [ON LIEN LAW, I
... „
DESIGNER/ENGINEER: x Not Applicable
_
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
I
Address:
City: State:
City: State:
Zip: Phone:
_
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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
is in Home
which conflict with any applicable 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 finan 'ng, tault with lender or an attorney before
work or recording our Notice of Commen
.cornmencing
Signatu o ner/Lessee/Contractor as Agent for Owner
_s
Sig u e of Contractor/License Holder
STATE F F ORIDA
Luc 2
STATE OF FLORI A
COUN _- -_ S -, t
COUNTY OF � C {fc•` C _
The forgoing instrume t was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20by
I
this 22day of 20 by
Se h 6v 18
WAyw
(Name of person acknowledging
(Name of person owled ' g )
(Signatu otary Public- State of Florida)
ISlignature of Notary ic- State of Florida )
rsanally n OR Produced Identification
P rsonally uce ' �IYtGIr INS
Typ Notary Public- State d
pe of I en ffic i P o d
1 a N0 `$�°a Pion aI}
CommissioCosfrWiifln #GG 071722
Wo.
My Comrrl. Expires June 9, 20
1 01149
o4/1 Q zs
Revised 07/15/2014
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