HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MU BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
SCANNED
Building Permit Application 13Y
Planning and DevelopmentServices St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1SS3 Fax: (772) 462-1S78 Commercial Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address:
Legal Description:
Property Tax ID #: L(S-Oa( —S�D t — OoDp — 004Lo Lot No.
Site Plan Name, Block No.
Project Name., 884 b9U,.�,e_
-Setbacks Front Bacic Right Side: Left Side:
CONSTRUCTIONDETAILED 1)ESCRIPT)ON OF WORK -
AddiTionalworKTOpeaerrormed underthis permit- check all that apply:
11HVAC Gas Tank Des Piping _Shutters 11 Windows/Doorr
11 Electric 0 Plumbing ElSprinklers 0 Generator Qtlolof
Total Sq. Ft of Construction: IS-00 S Ft of First Floor:
Cost of Construction: Utiffiries.Sewer 11 Septic Building Height is y
WE /T E.
OWNER/LESSEE
Name B5T
1Ict . .....
Name S
Address:
Company:ci.fA4_-� zep�4��fQ 1 �Z (7
City: state..
Addressi 140, 666C YQ13 I
Zip Code: 3W_:!T7 Fax:
Phone No. —,:Q 0 _T'SQ
city: Hcta� S:e� State:=(�_'
Zip Code: � -3cf Fax:
Phone No.
E-Mail-
Fill In fee simple Title Holder on next page (if different
from the Owner listed. above)
E-Mall:,1116ke (Z2
State or County_ License:7
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALCOIVSTRUL 0 N,FORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: I State: City: State:
Zip: Phone: I Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: 1 Zip: Phone:
I certify that no work or installation hl s commenced prior to the issuance of a permit
St. LudeCounlmakesnorepresentationthat isgranting apermit will authorzethe ermit 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 Hdme 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: Vour 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 lender or an attorney before
OF FLORIDA , A� ^ STATE OF FLORIDA if �J
fYOF milj' 41c COUNTYOF Af 7rd
The far o' instrument was acknowledged before me
this ay of _ moo_ 20 Llby
Personally Known _J
Type of Identification
Commission
Revised 07
Produced identification
The forgoi�ng,, instrument was acknowledgedbeforeme
thi415of �l.?�Q_ _ 20 by
Personally Known r� OR Produced Identification
Type of Identification Produced
Commission No.
KIERAN DUANE FRANPrON
EXPIRES. May 23, 2021
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