HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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: To Select from dropbox, click arrow at the end of line I
I
PROPOSED IMPROVEMENT LOCATION:
Address: AOi i h4ip_ �(lup C oif;2 -,D fL- 1�_&t4
Legal Description:y 0-4 ,-uC V-� AGS eloo h' u R Uh (d 3
Property Tax ID #: ��� V r — �� �1 ?j /0 -Z Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
i DEE TAILED DESCRIPTION OF WORK:
4(L CV)avy -T� d t-- L 1
I v L w Il�J�
CONSTRUCTION INFORMATION:
fti 5 rial worK to 5e er orme un Cer t is permit - c ec a app y:
DIVAC ❑� Gas Tank []Gas Piping Shutters ❑ Windows/Doors
11 Electric ❑ Plumbing 11 Sprinklers Generator ❑ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ <gy�
SFt. of First Floor: _
UtilitiestSewer Septic
OWNER/LESSEE: I CONTRACTOR:
Name I U6Yy IQ, (( C✓1
Address: 2 }}(Q 0'1
City: 0j A States/
Zip Code: 3, yq Fax:
Phone No. M0 - 3A1- 31
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
Name:
Company: Mk(��9S �'2/1�✓` ( X112I y��
Address:
City: PL4- S t q�(J�JC,Q State:
Zip Code: 3 � D Fax:
Phone No. %s- 0
E -Mail: _L)G'e-/Ycom eA
State or County License:C�425_5-:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
`_
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 thepermit 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 mu t be re orded and posted on the jobsite
before t first inspection. If you intend to obtain financing, cors' It wi lender or an attorney before
comrp,enging wopk orlrecording your Notice of Commencemen
S
Signature f Owner/ Lessee/Agent ipnatur Contractor Lice der
ATE OF FL0,RIp STATE OF FLORIDA
COUNTY OF IJZ4 COUNTY OF
knowledged before me The forgoing instrument was acknowledged before me
The forgoing instTy/:
this day of 20 dby this day om r 20 1 � by
,, J e-cG�L �l
(Nam o know dging) (Name of person acknowledging '
/
4(
(Sign ure of f Public- State of Florida) (Signature Nota P lic- State of Florida )
Personal) OR Produ tion ersonall�Kn n ORP DLLucPad lentification
o r} P4tMuced, T entification Produced "" `'-
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