HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABL I FO MU ZECOMPLETED 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: To Select from dropbox, click arrow at the end of line
PROPO-ED,IIVIPROVEMENT 4,56"A"_
Address:
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Address: 8 S 1-1 EL S, PL orLr ST L-0C4E' 'L-
Legal Description: Ott 3(070— Z7 r
Property Tax ID#: 31 Z7- 70100TY—DAU Lot No.
Site Plan Name: yIGT-5VL._ Block No.
Project Name:
Setbacks Front MA, Back: N Right Side: A// -�Left Side: N
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DETAILED DESCRIPTION OF WORK
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CONSTRUCTION INFORMATION .aa
Additional work to be nertormed under t is permit-cneck aWappy:HVAC Gas Tank ❑Gas Piping hutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ IIU Utilities: _Sewer Septic Building Height:
bW N ER/LESSEE CQNTR`ACTOR
Name VI !L4g4wA Name: 1c44✓k&t, 'w
Address: Company: SET( lL) (,(IM.WItAq
City: n4c'A-rte State:�� Address: Iyy fbawV
Zip Code: Fax: • City: State: F'C.
Phone No. 1 6967 Zip Code: 3t4 JgN Fax:(o'fL_g7Y!Z
E-Mail: Phone No. 2 -din &9?_-v0 cr>
Fill in fee simple Title Holder on next page(if different E-Mail: Al 1 c.tbgk-2.4 116-w-,—C Yy- 47N+
from the Owner listed above) State or County License: �'6G /�[7�3L1 3:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
St1PPLEMENTALkCONSTRUCIIC?N llE1�I lAU1/411 FORMATION
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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 thepermit 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,swimm4oniyour
fences,walls,signs,screen rooms and accessory uses to another n residential use
WARNING TO OWN ure to Record a Notice of Commencement may r ult i paying twice for
improvements to y r� Notice of Commencement must b recor ed a p sted on the jobsite
be"en
st in a Intend to obtain financing, co ��ith I der attorney before
cow r Notice of Commencem t.
s
�-ig-hatlrre of Owner/Less a ntractor a gent r Owner Signafure of Con racto ce older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF,' ;;r ,fit)('_/f COUNTY OF Sl ./-L)l1�
The forg�,If�g instrument was acknowledged before me The forgo* instrument was acknowledged before me
this�_9cy of /�l��•,- 20Z1,by this/L: i of Zyo/Y 20//, by
(Name of person acknowledging) (Name of person acknowledging)
(Signat e-of Notary Pub%c-StateoT Florida) (Signatu"rTof Notary Public- ate or Florida)
Personally Known.,,-'OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission No. rP AUMOND
AN MOND , �;
MY COMMISSION#FF 173907 :.: :.= MY COMMISSION#FF 173907
't :'a€ EXPIRES:December 7,2018
� q$` Bonded Thru Notary Public Underwriters �% j�f�y°••' Bonded Thru Notary Public Underrrtflers
Revised 07/15/2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS