HomeMy WebLinkAboutBUILDING APPALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPT
Date: vermit Number:
{jX
Building Permit Application
Planni"na and Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
-': PERMIT APPLICATION FOR: Windmjdom
I PROPOSED IMPROVEMENT LOCATION: I
Address:
Legal 'r?ri:
Property Tax ID #: Lot No.
Site Plan Name: Block No.
proms Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
9
REPLACE WINDOWS & DOORS WITH IMPACT". SIZE FOR SIZE.
CCU NSTRDCFJON INFORMATION: „
L�€I-IVAC [:] Gas Tank []Gas Piping
Elc-:=r;M Plumbing S ninklers
Total Sq. Ft of Construction:
Cost of Construction: $ _
�-I-_sh' u' [- tters i Windows/Doors
;! Gene —or F! Rosso Ro,
S Ft. of First Floor:
Utilities: Sewer I((lo�_I Septic Building Height:
4 101111�il1C� /1 CCCC- S �f1iTlt'Tl1.
1 416L ly L LL. a O 1 i f L f iJ :
Name € Dame: I
Address: I Company: FHIA LLC
_L € 3€�44 ,SW 42ND STREET
City: State: - x Address: I
Zip Code: Fax: ° Saete: P
Phone No. j Zip Code: 33312 Fax:
E-Mail: I Phone No. 954-884-8500
Fill i fee simple T <tie Hoklef on next page { of diluent F E-Mail: - LyI
9
i fromii abovel ` State of G3unty License:
if value of construction is S2SOO or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERANGINEER: Not A-pplicable MORTGAGE COMPAWY: Not Applicalble
Name: Name:
Address: Address:
City: i
State: I City: State:
i Zip: Phone. < Zip: Phone:
BONDING COMPANYz -e
FEE SIMPLE T ITLE HOLDER: Nag, Appkabl Not Applicabi
Name- Name -
Address: Address:
city:
Tin- Phone -
I certify that no work or installation has commenced prior to the issuance of a permit.
St- Lucie Countv makes no representation that is granting a permit will aUdw-he' the rm.1 holder to build the subject s--UL-.jre
;., pe
which is in conflict with any applicable Horne Owners Association rules, bylawsr and covenants that nnw restr� or prohibit such
struc:,Wre. Please consult with your H---m Owneers -Assoe-ati-an and;rew--Ap your deed for any reshin-irfions which m.Ti apply,
perrnent, 0-0 here-n'T agree the 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, swrn�mMfg pools, fences, wags, signs, screen room and accesswy uses to awtfw norf-residential use
NTilWUINO'VVNER�Your aureto Rrmurda Notice of Commencement nW resultin yompayingtsirkefor
th
improve.m.ent"s t'a yvour -pro-Ut'j, A kg— must be srzorded anid poi-ited on e jobsite
before the first inspection. If you intend to obtain finan consult with lender or an attorney before
commencing work or recording your Notice of Commend9t.
Al s
SiWnjiure of Owneq'LesseejContfactot as Agent for Own&. Contracto. -Lictse Folde:
STATE OF FLORIDA I
, STATE OF FLORIDA
COUNTY OF +- . 6pw,L%*CK( [COUNTY OF
Theforgoing iinsLrumentt was acknowledged before irne
insmanent was admow4exdged before rne
this Of I-V_ 20 21 by i this day Of 20 —by
INE THRIYMS MESMIF—F
(Narne verso
04'ame el persona of perso
(Signature N&y, Public- State of Florida 11 (Signature of Not ublic- State of Flodd
'ture of N'
PC.s:'-n3II'y L-town Perso!-�2.. urn
0RPrr_wd;_ucd'd_ers
-
Type Of f ica filf ��M
Notary Public State of Florida
Commission No. (Seal) Commission No. Je Miguel do
My Com MIM :a H 101149
Expires 04/19/2025
Notary Public State of Florida
Matthew Birkins
MY ComMission
'evise-d 1 17 1
HH 1 8385
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