HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPI
ICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Planning
Buildin%eAggg Applieatio
and Development Services , n
Building
.
and Code Regulation Division BY
23001rrmia
Avenue, Fort Pierce FL34982 St. LucieCounfii
Phone:
9772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMI1
APPLICATION FOR: To Select from dropbox, click arrow at the end of line-
v
Address:-
AD05 Ill R\ 6 - FT P\rrYQ C e
Legal Description:
Property
p rty Tax
ID #: 14 13 -COI-0002S- 0100 1
Site Plan
1- Cot No.
IFlame: (��S I �� P l C Y�0.b
Block No.
Project N
me: ��tnclrlp
Setbacks
Front Back: Right Side: Left Side:
DETAIL
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D DESCRIPTION `OF UUORK -
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CONST
UCTIOf INFORMATION }
A rtiona
wor to +e a orme un ert is permit—c ec a app y:
❑HV
C Gas Tank []Gas Piping Q
�Elec
_Shutters Windows/Doors
tric Q Plumbing 0Sprinkl�s
Generator Roof
Total Sq. F
Cost
t of Construction: S Ft. of First Floor-
of Col
struction: $ Utilities. Sewer Septic Building Height:
S E
J00
L-1,C. Name:'
IC,
OL 5 Company: �ioVtvi 'T0.
YD 0,-C,1 N State: kk Address: �O_\ 1�(e� v, Per
Zip Code:
ms
V, to Fax: City:-_�� Fie WC P-- State: %e
Phone No
'D 5 Zip Code: 3 y It $Z Fax:.11 Z 41e6 6 4 91
E-Mail:
PhoneNo.—1 S% 16633
Fill in fee
imple Title Holder on next page( if different E-Mail: Y\n3 d rnly `%(OI �py\q� (�yln
from the Owner
listed above) State or County License:
If value of 4onstructiion
is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNS
Name:
Address:
City:
Zip:
4 v
/ENGI EER.
t, h
-e 'vurvrfl
Not Applicable
IVIY
MORTGAGE COMPANY:
Name:. M1 l+r
s t"
Not Applicable
e
8bio b. \ aeJn rQ {t,i,
Address.
Vie rts- State:fC
(i—Phone:`1
City:
Zip: Phone:
State:
FEE SIMF
Name:
Address.
City:
Zip: I
LE TITLE HOLDER:
�n g q� �n+o�
T- Not Applicable
BONDING COMPANY:
Name:_ ►S\{�
Not Applicable
I
Address:
I
Phone:
City:
ZIP Phone:
I certify th it no work or installation has commenced prior to the issuance of a permit.
St Lucie C unttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in inflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. lease consult with your Home Owners Association and review your deed for any restrictions which may apply.
In conside thin of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accorclar ce with the approved plans, the Florida Building Codes and St Lucie County Amendments.
The followi ig building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory s Lructures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNINI 3 TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improven ients to your property. A Notice of Commencement must be recorded and posted on the jobsite
before th a first inspection. If you intend to obtain financing, consult with lender or an attorney before
commendinework nrrprni-dinavn.stun+;,-e,.Fr
_ Signat r o Owner/ Lessee/Agent Signatur of Contrac icense Holder
STATE LORIDA STATE F FLORI _
COUNTY F_Si WC LP COUNTY OF.
The forgRi g instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ay of Zp:(p-by this 2day of 20 Irby
dvAno
'3
(Nan of prson acknowledging) (Name of(Rerson acknowledging)
(Signature of Notary Public- tate of Florida) (Signature of Notary Pub ic- State of Florida )
Personally nown 7R Produced Identification Personally Known OR Produced Identification
Type of Ide tification Produced Type of Identification Produced
Commissio i No. ur ..t..: hw- Commission No. (Seal)
��racu
EXPIRES: September 13, 2019
vw,r rues uroem�9
REVIEW5
FRONT
ZONING
SUPERVISOR
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIE
REVIEW
REVIEW
REVIEW
DATE
COMPLET
Aq
INITIALS