HomeMy WebLinkAboutBuilding Permit Application AIL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 j
Date: co-HA- I'1 Permit Number:
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Building Permit Application JUN 21 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fart Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1575 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPflSEI IIViPRO1IEMEtVT
Address:_ ic>k'A^1anci 47t".
Legal.Description: i-Y,Ni A SL) -- fi r\ t re e-`rA--J 1014
Property Tax ID#l:_ a L(al- % 1 0\ Lot No.. � 1
.Site Plan Name: Block No.
Project-Name:
Setbacks Front Back: Right Side: Left Side:.
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�'• x� a ,e ec a app y:
_Shutters Windows/Doors
Plumbing ❑Sprinklers. 11 Generator O Roof Roof pitch
TotalSq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ , O Cd Utilities Sewer-[ISeptic Building Height:
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Name Name:
Address:_ L{trj� lC.c�c:-� jW1, � Company:.^ �) C_,
City: State:_1-2 Address:_ 44�L[ 12r-e—SS -e-r Lpq
Zip Code: f2�(5 S 2 Fax:_ /1,41l-F• City: A Q!`,2_ Sta1te:_C.-
Phone No. Zip Code: ?, Fax: 1/}
E-Mail: 0, fes, r C ZYkl Phone No. 722 1.6-" S 1":;-2
Fill in fee simple Title Holder on next age{if different E-Mail: L t o�n�', C C,� cc,_,, '; It,
from the Owner listed above) State or County License:
If value'of construction is SMOG or more,a RECORDED Notice of-6mmencement is required.
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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:
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 thatis granting appermitwill 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 gofthis-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 ezempt: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 jabsite
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.
Si wner/Lessee c[3ras Agent-fo-eOwner Sig r tactor/License Holder
TATE OF FLORIDA STATE OF FLORIDA
COUNTY OF `S ec.; c COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of _0t,,ne 20 laby this (q day of 20 by
Lie
(Name of person acknowledging} (Name of person acknowledging.)
r ,—c .__.
( nature:of Notary Public-Statwof Florida') ignature of'Notary.Public-Stabi of Florida)
Personally Known. v-' OR Produced Identification Personally Known V” OR Produ.cfd4dW ti cation, _
Type of Identification Produced Type of Identification Produced
JA
Commission No: �t SSS' .+ ea scion No. `1 655?fL. Jyat S�MRAU
_ COY Ptrblla c Sra a DN
JA3 MAW N u;h M olranli,>tlon. xlorltli
COMIS 1011 N FF 883$46 AIrBs Feb< .20 20
Revised 07/151201 %��°'�R.`` �Y Comm'.Eaplres Feb.28,2020 20
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS