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HomeMy WebLinkAboutBuilding Permit Application : ALL APPLIC. LE INFO MUST gE COMPLETED FOR APPLICATION TO BE Date: ' : - Ct_j '� ACCEPTED I Permit Number: Building Permit Application Planninggn bevelopmentServices • Building an ode Regulorion Division MAR 2 9 201 2300 Virglni Avenue,Fort Pierce FL 34982 Phone: (77 462-1553 Fax:(772)4624578 Coni , mercla! Residential , PERMITA• Pl,lCA71QN FOR; To Selectfr - om dropbox, click arrow at the end of line Address: 01 `fT .,,`.,�.;:•:• Legal pescrip on: I a, r Property Tax Slte Plan Na Lot No, Project Name Block No. �— 5etbacks F tack: Right Side: Left Side: • ct v� lxxkcc r I ion w to e e orme un er spermit—C ec a .:5�, .,::•,_-::.;.;;;•. HVAC �': apP Y� Gas Tank Gas P' !ping Shutters Windows/Doors Electric i! ❑Plumbing ❑Sprinklers Generator Roof Total Sq. Ft of Pristructlon: S .Ft.of First Floor., Cost of Constr ;tion:$�QQ Q Utilities:'nSewer Septic Building Helg ht: Name i ' � Name: (� Address: !h s Company: p Y: City: State: Address:. �D Zip Code: ( Fax: City: �'SL� State: P Phone No. Zip Code: Fax: E-Mall - Phone No. Fill in fee situp i`!Title Holder on next page(if different E-Mail, from the Own ;listed above) State o)r ounty License: If value of const I tion is$2500 or more,a RECORDED Notice of commencement is required. I; •„Lit i.'d�'i..,�.;.� ©ESIGNERJE 13INEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: city State:_ City: State: Zip: Phone: Zip: Phone: EEE SIMPLE TLE HOLDER: __Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address,• Address: City: '' City: Zip. I. Phone: Zip:. Phone,, I certify that nc ork or installation has commenced prior to the issuance of a permit, St.Lucie count ake no representation that Is granting a permit will authorize the permit holder to build the subject structure which is in can T witt any appilcabie}tome Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Pleas onsult with your Home owners Association and review your deed for any restrictions which may apply. In consideratio f the granting of this requested permit,i do hereby agree that I will,in all respects,perform the work In accordance the approved plans,the Florida Building Codes and St.Lucie County Amendments. The following b tdIng permit applications are exempt from undergoing a full concurrency review,room additions, accessory struc res,swimming pools,fences,wails,signs,screen rooms and accessory uses to another non-residentlai use WARNING T 1,6WNER:Your failure to Record a Notice of Commencement may result in your paying twice for imp ovemen to your property.A Notice of Commence ent must be recorded and posted on the jobsite bef e the fi :inspection. !f you 'mend to obtain financi ,consult wit lender or an attorney before . cam encine rdin r Notice of C4rnmenc ent, VA Signat s re of ssee Sig a ure o Co ra ice se Hold STATy' OF P � !IDA STA E 0>: ORIDA cou O �i - cc�u oris. The for Ding in �cprnent wa acknowledged before me The Forgoing instrul ent was cknowledged before me this day 20 a by this day of w,20_-I by - = -- � tName of p a:knows ing} Wame of p �onack�nowled�_g) i I aiy Public-State of Florida j ISI tura of Not y Public-Stateof Florida) gnatute I Personally lino Produced ldentlfication Personally Known ✓ OR Produced identification Type of identif, �+� _ Type of identification Produced Y�INE RUSSELL JE ALYNNE RUSSELL Commission ` c Stfs BfJFiariisa Commission No. State of Flarloa Expires Jul 22,2017 3y_+« rY1y C`:,�.. Expires Jul 22,2017 At EF 03832 Revised 0• REVIEWS l ��RONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE �(OUNTfcR REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE ` INITIALS