HomeMy WebLinkAboutpermit applicationPlanning and Development Services
Building and Code Regulation Division
Z9U0Virginia Avenue, Fort Pierce B9498
Phone: (77l)4G2'1553 Fax: (772)462'lS78 COOl[D2rci8lResidential Av
box, click arrow at the end of line
Address:
Legal Description:
Pmperty��0� 3
Site Plan Name:
Project Name: LOT- I 4ME)6
Setbacks Front Back: Right Side: Left Side:
HVA[
11 Electric
Total Sq. Ft of Construction:
Cost of Construction: $ _71so
-_ —~
Sprinklers
Shutters
FIGenerator
PL of First Floor:
Ub|�es�L~�/Sewer L=�5eptic
Lot No.
Block No.
| |VVindows/Doors
1-1 Roof �j Roufpitch
Building Height:
OWNER/LESSEE
'CONTRACTOR -
Name
Name: Vhvk�
Zip Code: ?Dk-O I�U Fax:
Phone No. �Az
City: (vN:7(- — State: -EL
Zip Code:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E -Mail: dcxmn��k c�bkMLAM (�_) ho
State or County
Kvalue of construction m5250Vmmore, aRECORDED Notice mmmmenc,mem:naqu/np.
SUPPLEMENTAL CONSTRUCTION LIEN, LAW INI ORMATION
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
EEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 thepermit 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 f' inspe you intend to obtain financing, consult lender o attorney before
comm InR w r c ding your Notice of Commencement.
as Agent for Owner I Signatu
t� sSTATE OF O, i
i i OF
The fp; ing instru ent was acknowledged before me
this ay of 20 0—by
(Name of person acknowledging )
t _a��
(Signature of Notary Public- State oflo ida )
Personally Known >< OR Produced Identification
Type of Identification Produced
The forgoing instrumpnt was acknowledged before me
this 'lay of -c " t 20 by
lavp_ V_V,
(Name of person acknowledging)
l H
(Signature of Notary Public- State of Fltd a )
4
Personally Known OR Produced Identification
Type of Identification Produced
AR A. Doreen Langford
Commission No. NOTA(C*UBLIC Commission No.
E STATE OF FLORIDA
Revised 07/15/2014 '#C_E ' Expires 12/5/2020
A. Langford
NO�PUBLIC
STATE OF FLORIDA
Expires 12/6/2020
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