HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 51A,-7 //u 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 V'- Residential
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side
`fa , i t{ 5 V.W
mom f-1 q-vC.to o
1�VAC
❑ Electric
❑ Gas Tank
Plumbing
Bas Piping
U Sprinklers
Left Side:
ISM
❑ Generator
Block No.
,j_1_rK 1.40 W L_
'Tern(.vlJ-a CAJg'4
L� Windows/Doors
❑ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
t. G E� �.
Cost of Construction: $ '� Utilities: _Sewer ❑ Septic Building Height:
OWNER/LESSEE.7 CONTRA, > UR:
Name LX_-5riS Name:
Address: , 396 l ixi . fn r CAC" RJ . Company-.SaL401e-1t
City: F - Pi earc-e_ State: F(. Address: qb'l
y
Zip Code: 344 921 Fax: N 4 City: • . i ew-c-�P__ State:
Phone No. -77 a At46 —i'7`1 q Zip Code:,/ FaxNV) 66O ySit
E -Mail: N i'+ Phone No. (771? Q- , 377
Fill in fee simple Title Holder on next page ( if different E -Mail: 5nL4J e�r5abol i n avl L�
from the Owner listed above) State or County License: OA &W I & S% `1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
of Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: --jiNot Applicable BONDING COMPANY: vIllot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or instal lation 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-residgntial 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 inspction. If you intend to obtain financing, consult with lender or an attorney before
commencing wgor recor�jiwtg your Notice of Commencement.
/ Lessee/Agent
STATE OF FLO
COUNTY OF, +- v
The forgoing instrument was acknowledged before me
thisdayof , 2oLLoby
(Name of person acknoowwll eg )
(Signature of Notary Public- State of Flori4
SABRINA L. BL K Jam\ c;•p'�I^�Slp '�.�'�'i�ii
Personal) Known OR Produc�l I o
Type of Identification Produced
Commission NoA- I ci-37yIFF195337
9 &'nded 1hN �" • O
��i���A' • �AG61k UnA%�;''�O \���
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
/License Holder
STATE OF FLORID
COUNTY OF s�'� ,
The forgoing instrument was acknowledged before me
this R7day of rn10-1 . 20 ftP by
eL1D t <� AA4 A w✓
(Name of person acknowledge g )
�er1N411111i111r�,�
(Signature of Notary Public- State of FWida,�
SABRINA L. BL6CX_�
Personally Known OR Produce i ntifiVti,6n�
Type of Identification Produced = :
IIEF
:
Commission No. krr ) q S330, 1 4' F1�t, ;;••�Q���
SUPERVISOR PLANS
REVIEW REVIEW
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