HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB E1INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ` Permit Number: f
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 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRC►POSEDIl1)PROVEMENT LC+CACTI �a ' KC0 42
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Address: 14091 C6LVOIC bXnniane,
7�
Legal Description: (� 1 9 SIT�� ( 0D , )S P—NE, c, U,AC1 C CORA
Lks� 0"4e KYAKIMI (6 I
Property Tax ID#: 25�, � � Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
OW
D 'AILED L�€ECPTIt3NF WORD ,£ f
,I(11 ala Q'V I S U)I r d, Y�, 160 �� ILA L �f(i• L4
IPEi� � � L 0 WS A IRS
IN M i KAo 8 UI L,,or1\IG (g V 1(VP0VV5) AND
Acid
itiona I work toe e Orme under this permit—check a appy:
11HVAC E]Gas Tank ❑Gas Piping _Shutters EIWindows/Doors
11 Electric 1:1 Plumbing []Sprinklers Generator Roof
T otal Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 7, Utilities:����• Utilities: Sewer E]Septic Building Height:
C} iNR/LESSEE. _ 4t3NTRACTC}Rk � kr
.; �.�.
�., . . .
Name 1 ame: _ I.
Address: ,ypi Company:
City: State: ✓ Address:
Zip Code: Fax:_ City: 'i ate
Phone No. + • ( ' Zip Code: �( p7 Fax: 2 Z `(J
E-Mail: Phone No. 2
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 'aiZ.
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
pp MORTGAGE COMPANY: _Not Applicable
DESIGNER/ENGINEER: _Not A licable
Name: 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 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 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: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 our Notice of Commencement.
f2oc�.J s
lgnature of Owner/Lessee/Agent ;2TErOF
a e'of ntracto icerise Holder
STATE OF FLORIDA FLO�IDq►, .
COUNTY OFA l uCf COUNTY OF n,dd,,�tay) I V�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this/]Y-4ay of 20/5 by this I day of r-U //2��0 by
(Name of person acknowledging) (Name of person knowledging
(Signature of Notary Pu Ric-State of Florida) (Signature of Notary ublic-State ofVida)
Personally Known. OR Produced Identification Personally Known I/ OR Produced Identification
Type of Identification Produ ype of Identification Produced
JOHN SCOTT
Commission No. FI lob rryas mission No.F /�95 S
X IBES:July 15,2418
OTHY C.LEGGETT
Thru Notary Public Underwriters * MY COMMISSION#FF 159015
"'IRESI Sep!eirlbei 19 2018
Revised 07/15/2014 N�ArFOF FI�P\OP Bonded Thru Budget Notary Services
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS