HomeMy WebLinkAboutBUILDING PERMIT.PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `J -1 e - < le
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: rl 9W L,06+ �C obi?
Legal Description:
Property Tax ID #: 3 4aY - 7 V k - t)6 Ll I - 0 b H, Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
L 11<f- Llltc !ZT�A 11,5*t,r ov-V loft,
nal work to be pertormed under tnls permit-
-Mechanical
ermit-
_Mechanical _ Gas Tank _ Gas Piping
— Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ %
apply:
_ Shutters
_ Generator
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
Name 140b" TYl acQbj- �)*I%i (%nkWCLM
Address: 99M., L, -')k-
c
ity:
h•City: -Pof'4- Sk Lo&e. State: FC --
Zip Code: 3-A 9 5a Fax:
Phone No. n')a • s�� 3Lia t
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Block No.
Windows/Doors
Roof
Building Height:
Name: CUctts So'wrnon S
Company: (',us-r"M R t c- 5� S fe was N(,
Address: l( IS S & T i IlaQ �i-,wA r
City: PC T ST Lk� CIState: F -L.
Zip Code: 342 Fax: 77; J3S
Phone No. 771 33,5 „332
E -Mail: C-usfiQ�r- Su t V Gc i •� crn __
State or County License: CA Cc 5 IS /O
if value of construction is26Kor more, a RECORDED Notice of Commencement is required.
71'00
s
INFER: _ Not Applicable
Name: _
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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
commencine work or recor�klpg your Notice of Commencement /�
Signature of Owner/ Agent/
STATE OF FLORIDA 1
COUNTY OF — Luc 't Q,
The forgoing instrument was acknowledged before me
this Jday of , 20� by
o
(Name of person ackno ging )
Signature of Notaryriilic- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. FF ol11 x15 *
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
Signature of Contra ctor%License Holder
STATE OF FLORIDA
COUNTY OF S�- LUC le -
The for oing instrument was acknowledged before me
this 1 � day of VV_l 20_1(p by
I • \ l o n Cs
(Name of person acknowledging)
CGJ
Aigna�turelof Notary Pub' - State of Florida )
Personally Known '1-11 OR Produced Identification
Type of Identification Produced
DEBRA L DONE
* MY COI�IISSION t FFf3'
EXPIRES: September 52019
r ° DEBRA L JONES
mission No. f"�c� a�5�lJ �' aCOIJAUS .#FF22757;
* *EXPIRES: September 5, 201
SUPERVISOR PLANS
REVIEW REVIEW
VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW