HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED 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
Address: in V ceafi Tkq
Legal Description: Oce LLV `VI diu 11j)(4 Ize
Property Tax I D #: 352Z-1oo18"O 014-000
Site Plan Name: i_f, )r)n
Project Name:
Setbacks Front Back: Right Side: Left Side:
F WORK:
e
-e
say
10 kW hem
Lot No.
Block No.
Electric ❑ Plumbing Sprinklers
Total Sq. Ft of Construction//:
"Y
Cost of Construction: $ 4,'700.
U Shutters
❑ Generator
S�Ft. of First Floor:
Utilities: RSewer Septic
Address:L Y)_ W i 1�, _
City: P. State: UN
Zi Code:lo Zip Fax:`�7?2 -3"-C?"'?
2r1
Phone No. -7 ? 21_3g8 ^ 61e72.5_ ,,,.
E -Mail: (,�� os3Yvi"n QCCw evmco-4. niO
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
NameNJ"f
Company:
Address:
11 Windows/Doors
F]Roof
City: <_ - lt-J e -
Building Height:
Zip Code: '7 Fax.777-3q$R" ;?"7
Phone No. —7— Z 39
E-Mail:zmaflo (2c eo—COMMA" l�
State orrouyLicense: M2��
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
State
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable BONDING COMPANY:
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
Not Applicable
State:
Not Applicable
St. Lucie County makes no representation that is granting a permit will authorize the permit 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 record' your Notice of Commencement.
_ Signatu ner/ Le ee/Agent Signat ontr'`actor/License Holder
STAT ORIDA ST OF FLORIDA
COUNTY OF err LU C_ t COUNTY OF D 4(c I
The for oing instrument was acknowledged before me
this T day of 6e-0bor . 20 Eby
�-e �� `-i C ►� �sma.n �
(Name of person acknowledging )
9(4y. kt,�
(Signature of Notary Pu lic- State of Florida )
The forgoing instrument was acknowledged before me
V
this day of 001W . 20 &I_ by
C VC S Si'v�G�r�,Y�
(Name of person acknowledging )
9�1 A/ZL��� r"X C e �P�C-tGL (rC
(Signature of Notary Public- State of Florida )
✓
Personally Known V"" OR Produced
Identification Personally Known OR Produced
Identification
Type of Identification Produced
Type of Identification Produced
Commission No. AGO%
�
!c��i) Commission No. i i-0C9ada
, �..4Seall
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KRISTINA L LOUDERBPCK
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L LOUDEROAC;\
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Revised 07/15/2014 ' af°�'.
EXPIRES August 7. 2017
398-0153
EXPIRES August 7. 2( 7
(407) 398-0153
FloridallotaryService.com
(407)
FloridallotaryService.cc ;
REVIEWS FRONT ZONING SUPERVISOR PLANS
COUNTER REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW