HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 J�' Permit Number:
__,,....__...._._.._.__. __._r.._...__._..,.. 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:
PROPOSED INPROVEMENT LOCATION, _
Address:``4�T/�
Legal Description: JG ✓QpbG CI u. Pl cti J 1 ce e 131 k LJ /m-{-361 6 fZ
Property Tax ID #: 3 y,�S - 7 - C) i Sy -BOO - Lot No..361,
Site Plan Name:II Block No.�
_
Project Name: 5hkNC e FP C G0
Setbacks Front Back: Right Side: Left Side:
C
CONSTRUCTION INFORMATI
_Mechanical _Gas Tank _Gas Piping _Shutters ' Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator Jc Roof
Total Sq. Ft of Construction: I ? Q o Sq. Ft. of First Floor:
Cost of Construction: $ 6, say . e 0 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR
City: V51-- State: FL'.
Zip Code: Fax:
Phone No. 26 -J0246
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Compa
City: }fie S,6[A^C( State:FG
Zip Code: 33 1) 7.5'- Fax:
Phone No%2 - S 6 -
E -Mail _ n rion % i,,q .i0."7
State or County License C(
If value of construction is 2500 or more, a RECORDED Notice of Commencement is
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
X Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY:
Name:
x Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and mscanauun ao
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
structure. Please consult withpyour Home Owners Association and reviebylaws
your deed for any restrictions talons which may applyhibit such
In consideration of the grahting 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 recording your Notice of Commencement.
�� Ati= -
Signatur V
f Owner/ Lessee/Contractor as,Agent for Owner
STATE OF FLORIDA
COUNTY OF i1' "6
The forgoing instrent w acknowledged before me
this (O day of dddmmm20 b by
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Pck(evN
re of Notary Public- State
Personally Known Z�L OR Produced Identification
Type of Identification 1 -
Commission No.
REVIEWS
COMPLETED
STATE OF FLOT �I
COUNTY OF—
The
7 �l
The forgoing instru ent w}s acknowledged before me
this �O day of Aa S' ZOLby
Personally Known _,
Tvae of Identification
No.
FRONT I ZONING SUPERVISOR I PLANS I VEGETATION
COUNTER REVIEW REVIEW I REVIEW I REVIEW
,tem
- State of Florida Jv
OR Produced Identification
fjoiary Public State Of FIGMa
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SEA TURTLE MANGROVE
REVIEW REVIEW