HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUS I BE COI)4PLPTED FOR APPLICATION TO BE ACCEPTED
Date: 7 Permit Number:.
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:
Address:
Legal Description-Tnd I on'Zi ve Y- E5+,_cdxm-u-n t+ OS:Ti k-(a 4 LJD+:_5_5(wQ I(s5)(QR_
-2073 rrrr��
Property Tax ID#:. ,, Lot No.
Site Plan Name: Block No..W
Project Name: CUM\J T=CJf)9Qk
Setbacks Front Back: Right Side: Left Side:
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Additional work to be-performed under this permit—check all that apply-
-Mechanical —Gas Tank Gas Piping Shutters "Windows/Doors
Electric —Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer —Septic Building Height:
Name-T6M i Name:
Address: Ow Affin ecan Natv Company: ��4& e 01r, &CW 64Pres;sion
Crate ib"
City: ,)uno-bwch State:FL Address: f0b Toma'haok 554M 'D/-
J A.
Zip Code:SDQMFax:rJ city: Indian A-�rbve, lge---k State: Ff
Phone No. t5a,)561 _252111 Zip Code: 3Z 37 Fax: . 32-1- 777- W341
E-Mail: WA- Phone No. .772-337-#1-1-70
Fill in fee simple Title Holder on next page if different E-Mail:—W-r-5sh auntl OP Vak Co-c 0,A
from the Owner listed above) State or County License:_94_�,�!]
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
IL_ 11
SUPPLEMENTAL CONSTRUCTION LIEN LAW MAI,
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
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
commencir&work or recordin o r Notice of Commencement
s
_Signature of Owner/Lessee/Agent Signatu ontractor/License Holder
STATE OF FLORIDA STATE OF FLOR A
COUNTY OF Ttt � C1 COUNTY OF ard
The forgoing instr e t was acknowledged before me The forgoing instrument was acknowledged before me
this 5L day of 20 4by this 3L day ofMiatCh 20 W by
S
(Name ers ledgi g) (Na ers ovule gi g)
(Si t e blic- tate of Florida) (Si n r ubli State of Florida)
Person I nown R Produced Identification Pers o ally Known OR Produced Identification
Type of ti ' ion o (iced Type o entific Prod 1 -----
/I''',''''--ccam�,, ,tiyt+r�,..�� BROOKES7JGETl OW,?P' 1 BROOKE SZIGETI
Commission No. CtoU✓ E; al�uIYCOMMISSIONNFF2 o ission No FF r. MY� IRE SION#FF244655
19
EXPIRES:June 25,201 { ` eondedPThmNmaryJuPub�eudCervmtens
BondedThm PubrxUnd ns
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS