HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: -71
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:
-Ioc i A Y4hios 12d
Legal Description:
PnQq - 1Q20-2
Property Tax ID#: I 82(1-- Lot No.
Site Plan Name: Wwav- Block No.
Project Name: V'iftld hJLVYak
Setbacks FrontBack: Right Side: Left Side:
Imf&(l like Cot like- aafalt- door
Additional work to be performed unleir Is 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:$ 1ILP15.0() Utilities: Sewer Septic Building Height:
Name-D-Chlowd Jq0VVC[V Name:
A r"n r)a WA-tp�—
Ito AIhUM V 4
Address: Company: Mal EoVernrise oe
city: M State: Ft-- Address: 1105 -roe"aba)k 'D,,-
Zip Code: cFax: WA city: 1"di-M P-q>vz' Qeach State: F1
Phone No. CA 171) c Zip Code: .3Zq37 Fax:. 341- 777- YZ3 q
E-Mail:-WAPhone No. -
7
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Fill in fee simple Title Holder on next page if different E-Mail: tuJ-e-sshqqnno&
from the Owner listed above) State or County License: I
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
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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
commencinA work or recording our Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF N r�� COUNTY OF f YCkrd
The for oing instrument.was acknowledged before me The forgoing instrument was acknowledged before me
this_X day of 20 4by this Z)l day of 20 ILP by
CJ ot
(Name person ac n w edging) (Nam per k owl edging)
( i to N blit-State of Florida) ( n t o Public-State of Florida)
P son OR Produced Identification Pers n OR Produced Identification
TO f Identif lo Produced Type of Identificati Produced
r^y'
BR( KE SZIGETI SS tis�'r'
BROOKE SZIGETI
Commission No. :' __(SWOMMISSICNNFF244655 mmission No. L?al)MYCOMMISSIONNFF2
a° EXPIRES:June 25,2019 ; EXPIRES:June
25,20'! ers
!, 0. Bonded Thn,Notary
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS