HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: kociq
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 4-')06R -T 1--f
Legal Description: -.BLK.
Property Tax ID 2 Q,<1 OnS 60 0 • 2, Lot No.
Site Plan Name: Block No.
Project Name: --r6A c-.5 /0 fly
Setbacks Front Back: Right Side: Left Side:
K
5100R-T
Pic) vL41(_ 0-v-CLI-Vt_�
$Zoo
Additional work to be faertormed under this permit--_ cNeckaff_[�app y':'-
1 -1 .. RGas Piping Shut
13HVAC 0 Gas Tank —Shutters 12,Windows/Doors
i.JElectric F�Plumbing FISprinklers Generator ❑ Roof
Total Sq. Ft of Construction: L So. Ft. of First Floor:
_/4
Cost of Construction: Utilities:nSewer FlSeptic Building Height:
;
't&m W 1550-.5 0W Rim'.
Name Name:'. C-4
Address: Company:-7_.)41-1- Oc'�iac
City: State:Y Address: C-
Zip Code: Fax: city: i C, State:____
Phone No. Zip Code: Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page if different E-Mail:
from the Owner listed above) State or County License:
If value ofconstruction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Nat 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: J `Not Applicable
Name: Name: '
Address: Address:
City: City: I
Zip: Phone: Zip: Phone: 5
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
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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin work or recordingour Notice of Commencement.
&'ZO-e� 5*n==f IN
1,Signature of-Owner/-LesseeJAgent nature o Contractai icense,Holder
' STATE OF FLORIDA STATE OF FLO DA
COUNTY OF I J ci COUNTY OFG}
The forgyg instrument was acknowledged before me The forgoing instrume t was acknowledged before me
this�day of Sa,/1 9AjlLf 20 y'�.by this day of�c�i i 207 by
Q.�!
S I
(Name of person acknowledging) (Name of person ackndwledging')
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(Signature o�_M�r.@".Plublic-State of Florida) {Signat a of N ry Pub/li State of FloridaPersonallOR Produced Identlfication,� Personally Known L' OR Rroduced identification
Type of Identification lvo S t Type of Identification Produced I
..'i� RENDAN SCARLETT
�((ccam� �I1' fYPUf
Commission No. I CC3runsmastON#FF960076 Commission No. 2o�P.•,.-a o YoUI`
x,;, * ABY CUh h�1 ON 9 FF 951068
EXPIRES February 19,2020 i y 'Q EXPIRES:ApdI 12.2020
7) 'JA •b. Flondalloln•ySernlre.car `"Uf F'• ' '' c ye X
Revised 07/15/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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