HomeMy WebLinkAboutpermit applicationALLAPPLIC
Date:
0
NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Planning and Development Services
Building and Code Regulation Division
Permit Numbe
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462aw@15,53 Fax: (772) 462-1578
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Commerc*ia
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Property Tax ID #-&9b
Site Plan Name
Project Name
Setbacks F i
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sont Back: Right Side: Left Side:
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as Tank
as Piping
L4
NN�Y•
_,1 Shutters
Block No.
ndows/Doors
Electric U Plumbing Sprinklers L. -j- Generator LJ Roof
Total Sq.. Ft of Construct'i'on
Cost nf Construction:$ I_-
Sq. Ft. of First Floor
Utilities:
Sewer
tiCNUtonullUlfig rielgnt-v"s
00f pitch
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If value of construction Is $2500 or more, a RECORDED Notice
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DESIGNER/ENGINEER. Not Appli*cable MORTGAGE COMPANY. x Not
Appl'l'cable
Na e: Name.
I Address. Address.
C *1 t y State C,1P t y: State
I Z,1, P Phone zips Phone
FEE SIMPLE TITLE HOLDER:
- Appl'Icable
Name. arse.
Address: Address..
C'19 t y C'1'
z 6
1P4
Phone: z 1 sm Phoneb
M 4
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 the permit holder to build the subject structure
which is in con lict 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.
Inconsideration 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 clans. the Florida Building Codes and St. Lucie County Amendments.
The following building Hermit autflications are exempt from undereoiner a full concurrency reviews, room additions.
accessory structures. swimmine Wools. fences. walls. slfzns, screen rooms
WARNING TO OWN -ER: Your failure to Record a Notl
and accessory uses to another non-residential use
ce of Commencement may result in your paying twice foimprovements to your property: A Notice of Commencement must be recorded and posted on the jobs
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
nature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF � o_
%.�
The forgoing instrument was acknowledged before me
this day o
20 Eby
r
ite
1111111111111 01 1111111111111111111111111111 �illiillllllliillllllll1111111lip- 11111111111111
-e /,0111111111111111 S
S' ature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF.
The forgoing in
this day o
strumen
t was
Pt
acknowledged before me-
� 1 •
(Name of person acknowledging)
ignature of Notary Public- State of Florida )
i
Personally- KnowOR Produced Identification
Type of Identification
Commission No.
Revised 07/ 15/2014
SUSAN MONTENEGRO
Y C 0# GG O8W99
2, 20-21
LVI sv4m ThN WAVY Pubk U
(Name of person acknowledging)
Signature of Notary Public- State of Florida
Personally Known OR Produced Identification
Type of Identificat(on,
Produced
Commission No. SUSAN C"NEGRO
toil
� MY COMMISSION # GG 089Q99
+� tEXPIREI ADd qw�
Bonded Ttn Notary Nbk Ur4uwrgm
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