HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO M ST BE CO FLET D FOR APPUCATION TO BE ACCEPTED.
a - :fix
Date: ` Permit Number:
a Building Permit Application
Planning.and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Connmercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the erld of line.
PROPOEI'3( tPRf.? E11liTyyLC�A�T(3N
Address:
Legal Description:
Property Tax ID#: Loo n Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Sack: Right Side: Left Side:
,i x � . x�- r `a � 2. t fi,:, ��1` -r ,r � F a 3s
D"ETAiL` DDI�RIPT13'1�1 CSF 1Nt1RK' /x � I `= '>5� f _° ,
. �s"x
C--1 m fu (U 6Olb O.'I eFg-1 0-f-11bPr
WOO.
�re .C�I ,rw �•■:Y -- Fs -{ ;. '.{" [ €:.z, .r` ? s s . ttr,P .r` ,a^M f. �,.r,yv�� c i ?z�Y�T�I��I••O l�Ii��OR111F,�kTI� ti'�d � 4+�i�"� h?(� 1� �7 �7i`,k,Lk'i fi"t�d7!Y^M`ss'Sq k\L,�,S.y�'Y Jxt^e'i�^x£i R ��� ��3-,id 3�v` C���-. f `:
".max rx✓r� .ire.Yap ^ _ -.,?.�..� _�.'�'.."x�-.a .fi,�,;,.__..3 �,'�',. ,.c X.r+ i�lsa� r.�<"'i.;.�. .�f.; .5... '�t✓r?..r,'L^ ,x�
A stsona wor to e e orme un ert ss permst-c ec a :appy:
HVAC �GasTank ❑Gas Piping _Shutters .._Windows/Doors
Electric Plumbing 'Sprinklers Generator 00f
Total.Sq.Ft of Construction:' Sq.Ft.of First Floor:
Cost of Construction:$ 1: )1 rTaclb Utilities: Sewer Septic Building Height:
\� Y
\7
NameG.i1C144 1bf"''Lk �:-�C Name: IALVI A4:Pl
Address:C0L� J(-Lh 0],C'L%-ra CA-� ( tdC Company: "�2 it�Z 0,P&I M CL0.I'llbfuI
City: Or'10.10b Stater ' Address:- P,6 Bot ktht
Zip Code: 5�2V JCf Fax: LD-7-L(1.9 '-�'��� City: Jf _kS A-f:"" State: PZ6
Phone No.- `-461 41� Zip.Code 3tt 1 9,�. Fax:.-07--3,357 1�J
E-Mail: Phone No. -77�Z-
Fill in feesimple Title Holder on next page.(if different E-Mai! +C'kC` .l :b -TT•
from the Owner listed above) State or County-License: CAC U,5
I f�aalue of construction is$2500 or more,a RECORDED Notice of Commencement is required.
��� PY��F.r V���,.Va���T;•��,•�I�F I���i�W�I�J�.�I��R.�S������1.�C'M���'/\�8� C V�l,.y;f'1 kn�,�aaF $� £i h r t�Vxi �,S T� 2X s
:vs+ 2�.,.,r.��,:�k.iy .,,.,:';?�.�..>:,:.«,_r n... v„„x..�_.ti'..;�.�..e�._;Y,os �"'i?ras`<c.�.;�.r.•1`f "�t t .r^a�;�`Ft.<..d..sF..�hrh <£^zr �� .^s,�:� t, � f.,� „R,.,'.
DESIGNER/ENGINEER: . �IVot Applicable MORTG�IGE'COIVIPANV: _;IVot Applicable
Norrie• Name:
Address:.. Address:
City: _ State: City: State:
Zip: Phone' Zip: Phone:'
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: !_Not.Applicable
Name: Name-
Address: Address:
City: City;
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
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 of 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 thisrequested permit,l do hereby agree that twill;in,alLrespects;perform the work
in;accordance•with the approved plans,the Florida Building Codes and St.Lucie County Arnendments.
The following building permit applications are exempt from undergoing a'fuliconcurrency review:room additions,.
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to.anothernon-residential use
WARNING'TO OWNER:Your failure 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 our'Notice of Commencement.. .
_Sign' 'Owner/Lessee/Agent Signature:of n or/License-Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OI: laCA-17-.rf(15 COUNTY OF
The forgoing instrument was.acknowledged before me The forgoinginstrument was acknowledged before_me
this day of CX` 77Z,, 20by this day:of ZY �C3L, ,20 l by
C.l.l I/Ur A0A1-LeL_ LLt ltx'' i C7 C
(Name of person acknowledging) (Name of person`acknowledging.)
( g-nature oT Notary Public-State of Florida) (S' ure oNotary Public=:State of Florida)'.
Personally Known v*"- OR.Produced Identification Personally Known TVOR Producedadentifcation
Type ofldentikation Produced Type of Identification Prod`ced'
Commission No. "" JMag ADAMS Commission No: ,�;`' � co D ADAMS
Commission H FF 907740ion'4 FF 9V740
My Commission Expires'
:, �e My Commission Expires .yfta,n,
•-o;aey°`` January '
Revised 07/15/241
REVIEWS FRONT ZONING SUPERVISOR, PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS