HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit,Number: of —n
Date:
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- 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
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Legal Description
Legal Description: 7 35 40 FROM NE COR OF NW I/4 OFNE 1/4 OF SW 1/4 RUN S660.3 FT,TH W 539 FT FOR POB,TH CONT
W120.75 FT,TH N 150 FT,TH E 120.75 FT,TH S 150 FT TO POB(88)0.42 AC)(OR 3800-1516;151'+7))
Property Tax ID#: � u� ��tZ ' on ���� 7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side: r
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Additionalwor to e e orme under this permit-check all appy:
HVAC Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers 1:1 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ Utilities: —Sewer Septic Building Height:
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O/U1%iER LES CONTRAOR //ye�M / ,r
NameDay 1 cl r--R r L, Name: _�> kA Az) \1Y 7 9�JQVA
Address: �7 (�� u hc� ,(- o II Company: FY-Nut' Oro
city: c�c�- tll-QrCe- State:1d Address: N05
Zip Code: 7�pFax: q City: J;r.9< ',� State:
Phone No. Zip Code: �r�0 Fax:
E-Mail: Phone No. (9 \Gt 0 ,
Fill in fee simple Title Holder on next page(if different E-Mail:,)I,t
from the Owner listed above) State or County License:I
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required:,
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SUP,PhEMENTA��>�aNSTRI�ICl%C}N.hii�l�
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DESIGNER/ENGINEER: 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: I
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit. 1
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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Signature of Owner/Lessee/Cdlhtractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �.� COUNTY _SA_11 4 A 'n
The forgoing instr ment was acknowledged before me The forgoing instrurpent was'acknowledged before me
th!8%-t day of 20 1_by thiCN day of U)C3 1 20 J by
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(Name of per on ackn ledging) (Name of p on ac wledgI ing)
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Sign ur of Notary Public-State lorida) (Signa ure of N-otary Public-State of Arida)
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Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
„` NA INGRAM
Commission No. �} L Commission No. F-._ ,. ,ifs '
Notary Public-state of LASHAMN INGRAM J
_M Comm.Expires Dec Florida20,2018
VA��'•: Notary Public•State of fioriaa
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS i
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