HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAVV INFO R;iAMON:
DESIGN ER/EPJGiNEER. ! Not Applicable p%ALJFTGAGE COMPANY.
Name: Name:
Address: Address:
City: State: City:
Zip: phone: Zip: 'phone:
FEE SIMPLE TITTLE BOLDER.
_ _ _ Not Applicable 00HOUG COMPANYO
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Not Applicable
State:
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, 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 recordinR your Notice of Commencement.
SigrtB�ire of Owner/ Lessee/Agent
STATE OF FLORIDA� r
COUNTYOE 7-} _ L- c t le -
The fo going instrument as ac nowledged before me
this day of 24 1L,,_by
(Dame of person acknowledging)
Si A�ol=ntracto`rlLicense Holder
STATE OF FLORIDA �
COUNTY OF <>
The forgoing instrument was cknowledged before me
this day of e'• , Zfl by
(Name of p#rson acknowledging)
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida
Personally Known OR Produced Identification Personally Known ✓OR Produced Identification
Type of Identificatii��� — — - - ; _ - - Type of Identification Pro
;, MIKE Mollie MIKE MARTIN
Commission No. r Nollry "Wj Stm# a1 Florlds Commission No. 1=1111 - Stab of FWNS
• Comniloslon N FF 219951 Ilion ► FF 216951 it
My COMM. Empires Act 5.2019 My Ow. Ei#ims Apr 5, 2019 -
#N "W M"lal if�IQ16y ltd" Alin. � ##„�„ •�.,.. allo�pt MM AIan. �
Itemised 07/15! t
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
ARL APPI.IIG4BLE INFO MUST BE COMPLETIED FOR APPLICATION To BE ACCEPTED
Date: Permit Numben,
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 erW of line
PROPOSED IMPROVEMENT LOCATION:
Address:[ l
Legal Description:
Property Tax I D #: V40-7
Site Plan Name:
Project Name:
Setbacks Front Back: might Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Left Side:
Lot No._ . .
Block No.
muuiliuriai WOrK to og errormeu unser Enos permit -- cnecK au apply: I I
L_JHVAC Gas Tank E]Gas Piping _ Shutters Windows/Doors li
Electric 3 _l Plumbing Sprinklers Generator Roof
Cost of Construction.• $ S • Ft. of First Floor:
Total q. t o Construction:
u C) Utilities: 0 Sewer ®Septic Building Height:
OWNERAESSEE:
Natme,
Address:
City: O -c a c�. a. State:
Zip Code: `�(�� �- Fax:
Phone No
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:.
Company:
`,ti- _
Address: `�•7�5.
City: �� c �r. e- State:,yt
Zip Code: , J _/ S iso- fax: L( U-1 91 -7_
Phone No. ri- i� - ..
E -Mail: Z c.• ` r C09 2'_ c:+•, �� t,_ ,!
State or County License: C C i s f 36 5
If value of construction is $2500 or more, a RECORDED Notice of commencement is requimd.