HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE 1NFO.MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
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
pi1POSEfl ) JR, t)11IETRT �lJ7tol "
Address: G -
Legal Description: . I CL
i r ��� r� ��,�,� 1..A A- 'A -lin �t-
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Property Tax ID #: �1�- Lot No.
CG+o Plan Narita ]f ,V, 42 'Z�, Block No.
CTION INFORMATION:
CO�j=ona
or toa Dertormed under t is permit - checK
❑Gas
all twu appy:
W indows/Doors
0 HVAC Gas Tanis Piping
_ Shutters
❑_ Electric 0 Plumbing Sprinklers
1:1 Generator 0 Roof
Total Sq. Ft of Constru 'on: U 3
'0Utilities•
SQ. Ft. of First Floor:
] Building Height:
Cost of Construction: $ Sewer /�r-�% �" �.. Septic
O"l!ifi�tER/1.ESEE:
=> ON�'i�AfiQfi:
ds
Name �C`'_YL�-S 'k'Y`Q Li4i
Name: �R
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Add re 't �"l k,) Lk) r
Company: jUAVj -P�
City: State: -
Address: 220N (-?+_ 1M file? ✓i
Zip Code: `` - Fax:
City: ,ZCtT- 4- State:_EL
Zip Code: 3q I i Fax: L-( ( � -m -) (.,
Phone No.
E -Mail:
Phone No. � (pCP
Fill in fee simple Title Holder on next page (if different
E -Mail: �MY e i Co ri (-I tqr A E Q 417W:
from the owner listed above)
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIG
Name:
Address:
rife.
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Andress -
City:
Zip: Phone:
Not
State
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:J
Zip:—
Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
structure. Please cconsult with your Home owners Association and review bylaws ur deed for any estrictio s which restrict
or
apply�ibit such
in consideration of the granting of this requested permit, 1 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 Recor&a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Comme> cement must be recorded and posted on the jobsite
before the first inspection. If a intend to obtain financing, consiI with lender or an ttorney before
commencinIarkar recaryour Notice of Commencement ,
STATE OF FLORIDA
COUNTY OF
The for oing instrument was acknowledged before me
this day of LA, kL 20 -LP-by
1� �1
(Namepf person
(Signature of Notary Public- State of Florida )
Personally Known Kro�Jfei
Type of Identification Liah Ja G
gr My Commis" FF 180505
Commission No. CW Exp.raa 018
Revised 07/15/2014
REVIEWS
FRONT
COUNTER
DATE
COMPLETE
INITIALS
re
STATE OF FLORIDA i
COUNTY OF
The forgoing instrument was acknowledged before me
this day of . 20 I Lo by
Fr -(-,z>
(Name of perso cknow ing )
(Signature of Notary Pu lic- State of Florida )
Personally Known o$�J�arF�aa
Type of Identification iah Joar
Y I fs:ron FF 180505
a w Espims &ea f
Commission No.
ZONING
REVIEW IS REVIEWOR REVIEW v EVI WON SE EV EWLE I. REVIEW E