HomeMy WebLinkAboutBuilding Permit ApplicationFROM :cast electric FAX NO. :7725699775 Apr. 30 2017 6:30PM P2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: _/
Building Permit Application
Planning and Vevelopment 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
Address:
Legal Description: 1
Property Tax ID #: /4
ry 7
Lot No.26f -7
Site Plan Name: Block No.
Project Name:
Setbacks Front_ Back-, Right Side: Left Side:
6c:%Jeh� 6*VPS f- ioc,64- I Of)
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VF1dlWFJlr%L0UV,WllUFMt:U UllVCV
HVAC Gas Tank
Electric Plumbing
Tills
Flas
WVMfL—CneCK allapply;
Piping
Mutters
Generator
0 Winclows/Docirs,
Roof Roof pitch
11 :
[]Sprinklers
Total Sq. Pt of Construction: SFt. of First Floor:
Cost of Construction: $ 9W utilities -1 Sewer []Septic Building Height
City.
21p, Code:,? tJJFax:
Phone No.
E -Mail:
State: F/
Fill In fee simple Title Holder on next page ( If different
from the Owner Ils" above)
Name, —,f I XS � e– we -f
Company: C& g t
Address: 22 1 4-14.1Z , 1&ke- 4141-11/
atT. ve-�&4 State-_
Zip Code. -Z2'L3k-,f— Fax g—,
Phone No. 77 �
E -Mail.
State or County License:
if value of construction Is S2W or more, 8 RECORDED Notice of Commencement Is required.
StJ'PPLEMENTAL CONSTkRt1CTI0N LIEN LAIN INFORMATION €,
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DESIGNER/ENGINEER:
Not Applicable
FRONT
MORTGAGE COMPANY:"
_fNot Applicable
Name:
SEA TURTLE
MANGROVE
Name:
COUNTER
Address:
REVIEW REVIEW
REVIEW
Address: l'
REVIEW
City:
State:
City: i
State:
Zip: Phone:
Zip: 'Phone: 11
FEE SIMPLE TiTLE HOLDER:
Not Applicable
BONDING COMPANY: i
,_Not Applicable
Name:
INITIALS
Name:
Address:
Address: 1
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit. I
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?y' oom 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 resultin 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 organ attorney before
commencing work or recording your Notice of Commencement. i
Signature of Owner/Lessee/Contractor as Agent for owner
STATE OF FLORID
COUNTY OF �, r . ,Q-)
The forgoing instrument was acknowledged before me
this day of TYNn =20 aby
o!
(Name rson acknowledging)
( nit e o otary Public- State of FUrida )
Personally Known OR Produced Identification
Type of Identification Produced
f`..-a�� • � �3 ;..mak t'�
Commission No. %�y+ .,` fi,__.(Seall
LASHAH
9 * tvtY Comm _ 0Ldre Of Florid2
Revised 07/15/2 1&,-,3„i°;;4'�, Commiss on(ros Dec 20, 2078
- s Bonded tbnrr�ti .,_ FF 777249
STATE OF FLORIDA,'
COUNTY OF
The forgoing instrument was acknowledged before me
this /--9, day of 20 1r) by
(Name of person
(Skwdure of Notary Public- StaFlorida )
Personally Known I OR Produced Identification
Type of identlfication�-.r�oduced 4
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Commission No. .�" pt �,..,°�,�m,�� E L;A
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Bonded through National FF 777249
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REVIEWS
FRONT
ZONING
SUER PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW REVIEW
REVIEW
:{ , REVIEW
REVIEW
DATE
COMPLETE
INITIALS