HomeMy WebLinkAboutBuilding Permit Application i
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ALA APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j I 1 �)
Date: fl! ' 1 l• / Permit Number: 1 / 7// '
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Building Permit Application Nay 1 2��7
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 ReSidenpal �r
PERMIT APPLICATION FOR: To Select from dropbox, dick arrow at the end of line
Address: 3 ' 'TIZ
Legal Description: I f i;/1'td n C-00e,±14 SA
Property Tax 1D#:_ awl ii -7 01 C)QO n Lot No. I
Site Plan Name: -c 1 i Block No.
Project Name: &9 e14
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�HllAC Gas Tank �as Piping !„Shutters �WiridowsfDoors
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Electric Q Plumbing �Sprisklers �Generator �Roof
Total Sq.Ft of Construction: so.Ft.of First Floor: j
Cost of Construction:$ t7 Utilities Sewer E]Sep tic Build Height:
Height:
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Name CAv ri Name: ' ✓� IC. ,
Address: 0 Com;rany:_ l n�lGj G 5616
City: f i-al •(ce State:rL Address•(&U 2'11 6 ,1°P
Zip Code: �. � Fax: City: _ -D f d-?Z2P jC'Li State:,�L .
Phone No. Zip Corte:';�a,C'1(.P o2 Fax:' 72
E-Mail: Phone No.4)(.0-1 •3,10 a I
Fill in fee simple Title Holder on next page(if different E-Mail: •Q� C(,m G-I�"C Sal Q C o m
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from the Owner listed abmm) State or County,Ucense:
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if value of construction is$ZSOG or more,a RECOROW fdo s0ce of Cmmnencenxmt Is re lred.
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S(lPPtEMENTAt CO�lSTRl3CTtON L4E$ tA1lV 1�3i`3Rtl1ATl�t�:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: i _Not Applicable 1
Name: cs S,01 /-7-,41 Name:
Address:L,7-/ &1wewh2,vAl _ Address:
City: State:TIC City: I State:
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Zip: �; of• Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: { _Not Applicable
Name: Name:
Address: Address:
City: CRY-
Zip: Phone: Zip: Phone: I
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 roams and accessory uses to another1non-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 len a or an attorney before
commencing work QfTecordi-ng vour Notice of Commencement. I
_Sign re of Owner/ ent Signs re of Con /Lice H d r
STATE OF FLORID9 STATE OF FL
COUNTY O ' i(141�1AZ COUNTY OF— —i'1 tl ✓1 (I
The forgoing instru ent was acknowledged before me The forgoing instru ent was acknowledged before me
this JD—day of �/ 20 �by this 1 1 day of �j20 1!by
YYY�✓ In1nr t r�✓1 ✓`PYi
(Name of person acknowledging) (Name of person acknowlA OA
e Bing)
I
ature of ota Public-State of Florida Wna6re of Notary ub c- fate of Floe
Personally Known V Personally Known�� OR Pr cW Identification
Type of Identification K ; Type of Identificatl
MY COMttM��IS��SttI11ON#GG149063 AMANDA S WARREN
Commission No. ''' EXPIR�st7etober 08,2021 Commission No. •`- OMMISGG149063
;, d{ EXPIRES October 08,2021
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS