HomeMy WebLinkAboutBlocking Diagrams All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: l�l� • ��30
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
I
PERMIT APPLICATION FOR:
PROPOSED'iNPROVEMERIT LOCATI,(7N
CAddress
Legal Description:
rPr_opertyTax fD°# 31 • 701 • Q t3' D ID ,eLot No.
Site Plan Name: Bloc No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF 111lORK {q
x t #
Y
CONSTRUCTION NFORMATI(}N
�h
44
Additional work to be performedx under this permit–c ec all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters I' _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cosfof=Construction:$' . �� Ny(, Utilities: —Sewer —Septic Building Height:
aWNE ES EE: CONTRACTOR:
IR
aam`e" Names';.
Address: za 'Company:
City: r-� 1 P.rc-2 State: Address:
Zip Code: Fax: City: State:
i
Phone No. 5 ' &R04LO Zip Code: Fax:
E-Mail:LIM& COY)AW f, Phone No
Fill in femme simple Title Holder on next pUJe(if difPee t E-Mail
from the Owner listed above) State or County License
Lttf
onstruction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION 11 N LAW 1(VF�ORMATION, ,
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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 the permit holder to build the subject structure
whic'h'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 nori-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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
co),Qmencing work or recording our Notice of Commencement.
CSignature Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF J COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this S'S day of ,2011 by this day of 20_ by
6 r`A m_�
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificat� Type of Identification
Pro ced ; { Produced
igna ure of Notary Public-St a of Florida) (Signature of Notary Public-State of Florida)
Commission No. .. i NA INGNAIII Commission No. (Seal)
Notarru c-State of Florida
-•; My Comm.Expires Dec 20,2016
%1V1111111bb1L 1i IT it 7249
e rough Vag' r
REVIEWS FRON �Z�._._ ; —� ,1S�. i �/� " PLANS VEGETATION SEATURTLE'. MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW. REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
:�e_v_. 8/2/17