HomeMy WebLinkAboutBuilding Permit Application ALL APPLlC, LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -
Date: ' I Permit Number: I �'
'V-u
Buildirig.Permit Application MAY 01 201'
Planning anti Development services '
Building and ode Regulation Division PERN/iiiTfiiIG
2300 Virglni Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (77 462-1553 Fax:(772)462-1578 Commercial Residentialy
PERMIT A PLICATION FOR: To Select from,dropbox, click arrow at the end of line
Address:
Legal Descrip on
Property Tax #:-�>q �14 Lot No,
Site Plan Na Block No.
Project Name �Q�r•t �� �
Setbacks F nt� Back: Right Side: Left Side: y
iio a w a e er ormi' un er is permit-c e:Ci k a a
PP V:
HVAC Gas Tank ❑Gas Piping _Shutters Windows Doors
11 Electric 11 Plumbing Sprinklers Generator Roof
Total Sq. Ft of nstructi/on.: �7.5�-f S ,Ft.of First Floor:
Cost of Construction:$ 7►.` lJ„} utilltiestSewer Septic Building Height:
1111 111111 111�11 1�1 1!J
Name'Q-� v� Name-'Xl�
Lt IL
Address: �[ i/ Company:
City: Stater_ Address: LQ
Zip Code � Fax:" City: �SL state• �
Phone No, "1 Zip Code•��R�Z Fax: ,�� •(p_�
E-Mail: Phone No.'7 - 1
rill in fee limp a Title Holder on next page(if different E-Mail: ` C.
from the Own r listed above) State or 8unty License:
Lv
of const uction is$2500 or more,a RECORDED Notice of commencement is required.
DESIGNERJE GiNEER: Not Appllcab a MORTGAGE CQMPANY: Not Applicable
Name; Name;
Address; Address:
City: State: City: State,
Zip: Phone: Zip' Phone:
FEE SIMPLE . ITLE HOLDER: `Not Applicable BONDING COMPANY: Not Applicable
Name; Name:
Address: I Address:
City: City:
Zip: I Phone-
Zip: Phone:
I certify that n.work or installation has commenced prior to the issuance of a permit.
St Lt�cie Count makes no representation that Is granting a permit will authorize the permit holder to build the subject structure
wNlch is In con ct with any applicable Home owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Pleas consult with your Home owners Association and review your deed for any restrictions which may apply.
In consideratior of the granting of this requested permit,I do hereby agree that 1 will,in all respects,perform the work
in accordance v th the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following b liding permit applications are exempt from undergoing a full concurrency review:room additions,
accessorystruct ires,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use:
WARNINGT( OWNER:Your failure to Record a Notice of Commencement may result In your paying twice for
imp(ovemen to your property.A Notice of Commencer4ent must be recorded and posted on the}obsite
befcke the fit t inspection. if you 'nt to obtain finandr1g,consult wit lender or an attorney before
commencing din r Notice of Cornmenceinent.
Signa t re ofa ee Sig a ure o Co tra ce se HolSTAT � d
COU O Q RI \ COU STA E 4OF ORiDA W { .
The forgoing in ti- ent wa acknowledged before me The for Ming instrument yv s acknowledged before me
this� ay o Y1 20 Eby thlsay of `• 20__7by
(Name of ers ac no Iedging) (Name of per on acknowledge g)
a=
gnature of Lary Public-state oORf Florida) gn-ature of No ry�Public-State of Florida) " rn
Personally Kno n t_ Produced Identification Personally Known OR Produced Identification ;x {
Type of Identifi tion Produced Type of Identification Produced
M
2. 5ea1r � (Seal) c
Commission N -'� ( ) Commissian No. o
r
JERALYNNE RUSSELL "
Revised 07/ :512 *" Notary Public-State of Florida
,,pFfl Commission#FF 038392
REVIEWS F SO PLANS VEGE'T'ATION SEATURTLE MANGROVE
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