HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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: .�v-1 JI-El A�Vn
Legal Description: 111YFEWeY k- [1,N+2-PJIK'11 LC+_j (M(jj.�_5L{K2N) (Ci-
Property
ilrProperty Tax ID#: 0?,09-OGO-6 Lot No. j
Site Plan Name: �� ,,,,,,1�-! Block No. ��)
Pro) 1J
ect Name:� ULE 1w
Setbacks Front Back: Right Side: Left Side:
1-asicll like Cod_ likeyaoQ door
Additional work to be performed under this permit-check all that appy:
_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:$J,3�`J Utilities: —Sewer —Septic Building Height:
7City: T)01r4
•Vrt,elar-ct _ Name: 777777 �
16111 A,4t Company: MN1 E rise v4 Qxcurr� db� p�xie�,►b.r
LLxC i-e_ State:EL Address: i f0B 7ornQHawlr ai
Zip Code: 30'Ea Fax: u� I City: Lai-A 14—b— ee.6- State:_f7l
Phone No. (7-12)33(e-rAte Zip Code: 32437 Fax: 3ZI- 777- yZ3U
E-Mail: NIA Phone No. 772-337-4/y70 _
Fill in fee simple Title Holder on next page(if different E-Mail: SL u Er S. rw s��.wwo%, A'w
V from the Owner listed above) State or County License:
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required,
SUPPLEMENTALCONSTRUCTION LIEN LAW INFQRMATION:
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 con ict 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
commencing work or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF ORIDA STATE OF$XC.VaI'c.I COUNTY
COUNTY OFV
The for$ping instrument was acknowledged before me The Forgoing instrument was acknowledged before me
this day of J WV2 . 20 I&by this A day of AUS .20 Itp_by
_ Lu-fes Waktrillia LILlibits
(Nam arson knowledging) (Nam per a owledging)
( � n�tublic-State of Florida) ( t Public-State of Florida)
Pe OR Produced Identification Person nown '� OR Produced Identification
Typeroduced of Identification Produced
T''Ni�a, aROq-Row
y�WPa55i^„fir FF o ission No. 7.V+116fJ
Commission No. pG'p� RaI�EXPIRES:Juq 2s,ah :� I) WLUL1 �Gt7
'+ttiri; Bank inry Wyrgrt _...,...2
EXPIRESJOK 25 39
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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