HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COIWr- IL-r.TED FOR APPLICATION TO BE ACCEPTEV
Date:
SCANNED Permit Number:
BY
8t, Lucie County
Building Permit Applicatibn
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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
, PROPOSED
. ,SEG'1-IMPROVEMENTILOCATION
Address: 6
0Legal Description: le,2 kn, 14 PI'A &S
Property Tax ID #: -7C7,5-' 1900_V_ e?o 10 Lot No.
Site Plan Name: "i 6ti, 1 A eAa C M Block No.
Project Name:. ,
nai wo
rvi
allVAC Gas Tank
. UElectric E]Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ � � 27� , o 0
under this permit — cl
DGas Piping
0Sprinklers
apply:
Shutters
Generator
S Ft. f First Floor:
.US . ewer Ultili ties: Septic
Name (A pq
Address: 4*3 O r3 b K h 3gLt
City: ege4— mvt'-s
Stater
Zip Code: :13 -q Fax:
Phone No.
E-Mail:
Fill in fee'simple Title Holder on-fibkt page ( if different
from the Owner listed above)
If value,6f,construction is $2560 or more, a RECORDED Ni
;-p,
e of toinmeIncernent is required.
z
z
MWindows/Doors
E]Roof
Building Height:
Narfie: IFY) 1,CkA_e_ I Ck=—
Company: 777rk-u dF-0iZ,
Address: te( -5,
Ced
City: State_-_�i
Zip Code: 3_� Se�2 (0 Fax:
Phone No.
E-Mail:
State or County License: IR9!262;�_
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
Citv: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Add ress:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
city.
_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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 fWI concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-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 lender or an attorney before
commencing work or recording vour Notice of Commencement.
Signature 6f Owner/ Agent/ Lessee SignaturWof Contractor/LicgAse Holder
STATE OF FLORIDA l STATE OF FLORIDA
COUNTY OF COUNTY OF SA LA
The forgoing instrument was acknowledged before me
this � day of 20 14 by16
� )^ 4 k
Larne of person acknowledging)
of Notary Public -
Personally Known
Type of Identification Prodl.
Commission No. & USQS
Revised 07/15/2014
of Florida
Identification
LASHAHNAINGRAM
�. ($MMISSION # EE 050558
�lRES: December 20, 2014
:I Thru Notary Public Underwriters
The forgoing instr ent was acknowledged before me
this � day of i u u !a . 20-14 by
14
(Name of person acknowledging)
(Si ture of Notary Public- §tate of Florida)
Personally Known 0Produced1dentification
Type of Identification Producedt V�1 ern. S11'1
Commission j 11WEPI ,
`'EXF!RES
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE .
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
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INITIALS