HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE i MUST BE COMPLETED FORIAPPLICATION TO BE ACCEPTED
Date: PermitNumber:
.
Ouilding Permit Application
Planning and D ..
Building • . Code Regulation
00 Virginia Avenue, Fort Pierce FL 34982
Phone: 4. + .2-1578 Commercial Residential
PERMIT i RR1 °
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Address: Wo ypk C V-
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Block -73
Site Plan Name: i
Project Name: p
Setbacks Front Back: ight Side: Left Side:
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Piping Shutters Windows/Doors
PlumbingElectric • i •ai
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ t) tilities: Sewer Septic Building Height:
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Address: 6SID9 94,e- Company: Mi LVe
Zip ,� r. t
Phone No. 148 -7 • C=f-7
Phone
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simpleFill in fee i +' on page if different E-Mail:
from the Owner .. - - s r
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If value of construction is 2500 or more,a RECORDED!Notice of
ement is
quirei
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SUPPLEMENTALCO T'RUCTION'LIEN LAW INFORMATION
DESIGNER ENGINEER: _Not Ap liable 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: i Zip: Phone:
I certify that no work or installation has commence ld prior to the issuance of a permit.
St.Lucie County makes no representation that is gr nting a permit will authorize the permit holder to build he subject structure
which is in conflict with any applicable Home Owne s Association rules,bylaws or and covenants that may r strict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions whi h may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respect perfor the work
in accordance with the approved plans,the Florida wilding Codes and St. Lucie County Amend m t
The following building perm' plications are exe pt from undergoing a full concurrency revie : r m additions,
accessory structures,swi in pools, fen es,walls signs,screen rooms and accessory uses t ano er non residential use
WARNING TO OWN R: Y ur fai re t Reco d a Notice of Commencement may r suit' your aying twice for
improvements to y ur pr per . A N tice c f Commencement must be rec r ed a d post n the jobsite
before the first ins ectio • I you int nd to btain financing, consult with I der o an a orn y before
commencing wor or rec din ou Notic of Commencement.
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Signature of Own J Agent/Lessee Signature of Contr tar/License Halder
k
STATE OF FL IDA i STATE OF FLO DA
COUNTY OF aNCE COUNTY OF OR +cE
The fo ing i strume was aZk owledge fore e The fo¢�ing ins u en was a knowledg ore me
this day f 20 i "t'' 4 this—*$day 0 20 y
PETER A CAFA"III •� PETER A CAFARO Ili
(Name of person acknowl (Name of person acknowie ing)
( ignature of Notary Public-State of F orida ) (Si nature o Notary Public-State f Flor a )
Personally Known x OR Produced ldentifica6ion Personally Known x _OR Produced I entification
Type of identification Produced Type of Identification Produced
Commission No. EE 174164 mmiSSion No. EE 174164 P Caai1 j
YP+t. Notary PutNie State of Florida No Ty*�iJtil-c Stale of FtOfiO3
` Kari M Rice tioni ; Ka i M Riccaboni 1
a C . T t" Ccmmrssion E 17'i
} Or poi Ezpuev'05t2 2016 or no
Ex ires O5M/2016
Revised 07/15/20 14
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATUR LE MANGROVE
COUNTER REVIEW EVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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