HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAtL APPLICABLE INFO MUST BE CC. , ,ET
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462
PERMIT APPLICATION FOR: To
APPLICATION TO BEACCEP ,. Q
Permit Number: [ V }fin —Os ! &
Permit Application SC BN1NED
St. Lucie Countv
t
Commercial X Residential
dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 12200 West Angle Road, Fort Pierce, FL 34945
Legal Description: See attached 1
Property Tax ID
Site Plan Name:
Project Name: 63412935/Angle Road
Setbacks Front Back:
Side: Left Side:
DETAILED DESCRIPTION OF WORK"
AGGtnc� s-re�► -Ia-t�w�X; ���c� for t�eirl-P-o
CONSTRUCTION, INFORMATION:
INFORMATION:
Lot No.
Block No.
HVAC _Gas Tank I Gas Piping _Shutters Windows/Doors
ElElectric 1i Plumbing i, Spri klers Generator ❑ Roof
Total Sq. Ft of Construction: I S Ft. of First Floor:
Cost of Construction: $ /0. 000 I, 1,
Utilities: _ Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
e ti TOVt/(j'S �[
I
A-
I
Name: Benjamin Ekey
Address: 1 D il^P,J I d 6n J7 a.I W A-U
City: Oi I7hY%I
I I
Company: Atlantic Tower Services
Ii Statlg:7t
Address: 2544 E Landstreet Road
Zip Code: D 0 Fax:
Phone No. 2 1 — 2-&-4550
E-Mail:
City: Orlando State: FL
Zip Code: 32824 Fax: 407-636-3145
Phone No. 321-418-0162
Fill in fee simple Title Holder on next page
from the Owner listed above)
if diffe
hwinsor
accessats.comrent E-Mail: @
State or County License: SCC131150970
-- -- -- -•--••-..-_...,..... �- v. I - -.1 c, n nclv?..cvl�a�,uw 11 wrnmencement is required.
SUPPLEMENTAL CONSTRUC �V,LIEN 1 AW INFORMATION:
DESIGNER/ENGINEER: _ Not pplic�ble MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: N I Address:
City: I. Stat : City: State:
Zip: Phone: I; Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has
St. Lucie County makes no representation that
which is in conflict with any applicable Home C
structure. Please consult with vnur Hnme n..,n
In consideration of the granting of this reques
in accordance with the approved plans, the FI(
The following building permit applications are
accessory structures, swimming pools, fences,
WARNING TO OWNER: Your failure to l
improvements to your property. A Not
before the filstii�rection. If you inten
commenci e w or recording vniir N
Senior
of owner/
STATE OF F4
COUNTY OF
The forgPo�ing instrument was acknowlecig
this L"aay of 7CU1(,C_Gi q 20
0_4i +- \2bb .Iirl" / I
Notary Pgblic- State
Personally Known V11" OR Produced
Type of Identification Prodyged .,,,
Commission No.
Revised 07/15/2014
BONDING COMPANY:
Name:
Address:
Zip: Phone:
to the issuance of a permit.
_Not Applicable
anti g a permit will authorize the permit holder to build the subject structure
rs Association rules, bylaws or and covenants that may restrict or prohibit such
ksso iation and review your deed for any restrictions which may apply.
arm it, I do hereby agree that I will, in all respects, perform the -work
Building Codes and St. Lucie County Amendments.
;pt 1 rom undergoing a full concurrency review: room additions,
signs, screen rooms and accessory uses to another non-residential use
Notice of Commencement may result in your paying twice for
)mmencement must be and posted on the jobsite
ain financing, cons with lender an attorney before
Signature
STATE OF FJORD
;
COUNTY
The forgoing instrument was acknowledged before
me k; -a
this2S-hiday of tf (20 by
.
z
$
In, Ly/ -Y-%
(Name of IYerson acknowledging)
.l
of Notary Pu -State of Florida )
Personally Known 4 OR Produced Identification
Type of Identification Produced
Commission No.
(Seal)
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