HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /2 M /2o!Permit Number:
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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 1C•
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
I= PROPOSED IMPROVEMENT LOCATION:
Address: fel q H f\ zet w oo8 Dr , r-+ 'Recce . FL
Legal Description: c -i L av\q, w o n D Lor 3 3
Building Permit Application
Property Tax ID #: 2 y; -- .SOZ - 0033 —0 bo/ 7 Lot No. 33
Site Plan Name: /WA
Project Name: NA/
Setbacks Front Back: Right Side:
DETAILEDDESCRIPTION OF WORK:
Left Side:
Block No.
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CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit - check all
ID HVAC Gas Tank ❑Gas Piping
0 Electric 0Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ /6-6,10
OWNER/LESSEE:'
Name Mteba,ar--t- 6a -E ieA
Address: IISIA b
City: E_v r+ e r c. e State: -L
Zip Code: 3 +i 4 62. Fax:
Phone No. 777- -S a5 6 51-f
E -Mail: w, bPu$14e✓ C Ila /Lain" mein
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
apply:
J Shutters
U Generator
S 1:4 of First Floor:
Utilities: LI Sewer Septic
CONTRA OR: ..._.,,
QWindows/Doors
Roof
Building Height:
Roof pitch
Name: It c.ln t_ 9.0,/ `C). \ c r ti
Company: Ai I S�iswt c lA t ut 5 ; 1, 1, -V. , LLC
Address: 3 52- 9-64A
- 64 `A- 0 % (, e _
City: Cor I'� Pr3 GsC/
ln / '@.`` State: J L
Zip Code: 3 Z
Phone No. cal oo . 351 —B 5cr
E-Mail: c i a-4 vfFhv, e_ � a Ih on- 7 COWN.
State or CouLicense: CCC 1 32..61 e
If value of construction is $2500 or more, a RECORDED Notice of Commen
ment is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY:
Name: Name:
Address: Address:
City: State: City:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable BONDING COMPANY:
Name:
Address:
City:
Zip:
Phone:
Not Applicable
State:
Not Applicable
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 your Notice of Commencement.
•
ignature of Ow a/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 51Luc_AQ--
The
firgoilpg instrume nt as acknowledg d efore me
this y of A r . , 201 y
(Name of person acknowledging)
(Signature of Nota
Personally Knowri „,0.Z;0 :N
Type of Identificatkij
it
ublic- State of Florida )
Commission No.
Revised 07/15/2014
is the bn v
rJ Pu li tate of Florida -
•'umL rsaro� FF 234730
My Comm.May 27, 2019 f+
E , ,ded throuuh���s National Notary Assn.
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was ackn
this day of
(Name of person ackn !edging )
ledged before me
,20 by
(Signature of otary Public- State of Florida )
Personal) nown OR Produced Identification
Type of dentification Produced
Co mission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS
DATE
COMPLETE
INITIALS
COUNTER REVIEW
REVIEW REVIEW
(Seal)
VEGETATION SEA TURTLE
REVIEW REVIEW
s
MANGROVE
REVIEW