HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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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
PERMIT APPLICATION FOR:
Address: 10 r7o 1 '5�
Legal Description:
Commercial Residential
To Select from dropbox, click arrow at the end of line
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Property Tax ID #:CJI
Site Plan Name: f9b—V-p
Project Name: l r—yj Porro
Setbacks Front
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Gas Tank ❑Gas Piping _
Shutters
Electric
Plumbing
Sprinklers
Generator
Lot No.
Block No.
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $,
Utilities: _Sewer Septic
Name Pnn
Address: DO S,
City. State:
Zip Code:
Phone No. `7? 2— �cj
E -Mail: ��� (�L�y1�(rtC�-r
Fill in feesimple Title Halder on next page ( if different
from the Owner listed above)
Name:
Company:
Address:
City: Po/_
t___l Windows/Doors
Roof
Building Height:
State: R-1
Zip Code:,'
Phone No. -7-7Z—�JIP -
E -Mail:
State or ounty License: _ J-44 CO
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I certify that no work or installation has commenced prior to the issuance of a permit.
which is noconflict with any representation
aOwners Asssociatio permit will
or andpcovenaholder
ts that build
ay restrict o)rpstructure
oh bits ch
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 record'
---��� your Notice of Commencement. �
'Agent
Sign
rise Holder
STATOOLORIDAST��FLORIDA
COUNTY OF 1}- Luc � E
COUNTY OF 9t L-i,l C I C•
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Zfl day ofv�-tb er 20 L(,o by this'2q day oc�
.201 _(- - by
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(Na .,f Nenun
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(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
k ffi� C M S Crvl,a.r,,r,
(Name of person cknowledging )
iC r^/( c� CL ! �(
(Signature of Notary Public- State of Florida )
Personally Known / OR Produced Identification
Type of Identification Produced
Commission No. ;-'�G09
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Commission No. Ft D ae4,
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K iSTINA L LOUDER
Revised 07/15/2014
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EXPIRES August 7, 2017
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COMMISSION
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EXPIRES August
(407) 398.0153
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