HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
Building Permit Application
Planning and Develop I ment 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
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WO RKtof PR(Y31%
Address: I I Pee Pr- A Lt,_)
Legal-Description: eQU4
Property Tax ID#: 5-03 - CC)L q • 000- I Lot No.
Site Plan Name: Block No.
Project Name:_ 4
Setbacks Front Back: Right Side: Left Side:
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Additional work to be ertormed under tnis permit-check all mat apply:
1_JHVAC Gas Tank F]Gas Piping F]Shutters aWinclows/ggQrs,
Electric Plumbing OSprinklers Generator 01 Roof
Total Sq.Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 1 SO 2L- -7 Utilities: SewerF]Septic Building Height:
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Name -Docer-ti 'Be�t. -,e-, Name:
Address: k 15- f_1 14 L it,_) Company-'-D�4_(o Qo'i-Cve&_'-
City- -7!5-T+1 o4-r'A2J
State: Address:
Zip Code: 3 4 7 Fax: City: 1,0 Stater"--
Phone No. Ot -7 1.10 S-19, Zip Code:3 S q 1 3-- Fax: J1,I
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNERjENGINEER: ___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 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 recording our Notice of Commencement.
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E S►g anan turgaf(-j_r/Lessee/ gent �"Tre d5—Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
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COUNTY OF COUNTY OF a trvl
The for oing instrument was ac)c.nSorwledged before me The forgoing instrument was acknowledged before me
this, day of ,'e4*1V— 20 1 by this day of &10 V 20 by
r{Name of.person zcknNk* C OF NEW JERG ;/ (Name of person acknow dging)
f tit" r nMINIM plies 9198/2021
(Sighature�Notary O'ublic-State of Florida): (Signatu of otar Public- ate of Florida)
Personally.Known OR Produced Identification Personally Known ZOR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 70QY60i 21 (Seal) Commission No. o�ARYA�B��� AN��� UNG
* � .� ,¢ * MY COMh4�uSf0 FF 951059
N, EXP1R 9:Apt➢12.2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER--. JREVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS