HomeMy WebLinkAboutBuilding Permit Application 10/27/2017 14:31 7727811307 FLYNNS AC PAGE 01
ALL APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: )� Permit Number:
Building Permit Application OCT 2 7 2017
Planning and Development Services PER�IIITTI idG
Building and Code Regulation Division 1n,oi
Luce
St.
2300 Virginia Avenue,Fort Pierce FL 34981 y• F:;
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:
Legal Description. U 1
WILL46-C IN 13: 10 oj�, Saq )i
Property Tax ID R: Z O -000'.`7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left T Side-
14 c �" s y� s� r� ccs 14 A /o kioHf i
ls, 75 sE'P_P\
ora wor to b rtormedunder this perm --c ec a appy:
HVAC Gas Tank [7]Gas Piping Shutters ❑Windows/Doors
Electric Plumbing Sprinklers Generator ❑Roof Roof plash
Total Sq.Ft of Construction: 5 Ft.of First Floor:
Cost of construction:$ 67'22:2_c00 Utilities-SQ_
Septic Building Height:
Name 4 1 ada ne Name: Joe 4:LvAv)
Address-
Company: V f ri rr'
City. L, Stater Address;J
Zip Code:._ ] t r 9 d Fax: City: t 4 Z/ StateEL
Phone No. `�, ~{ )7 �/Q Zip Code:-34 q t-)', .._ Fax: '7 g I—fl2Q!l
E-Mail: Phone No. 1
Fill in fee simple Title Holder on next page(if different E-Mail: �v�i� i� , 4�►l'► QS .{1Q
from the Owner listed above) State or County License. -
,w
if value of conxtructlon Is$2500 or more,a RECORDED Notke of Commencement Is required.
10/27/2017 14:31 7727811307 FLYNNS AC PAGE 02
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:
ityZip: Phone: Zip Phone:
I certify that no work or Installation has commenced prior to the issuance of a permit,
St.Lucie County makes no represent tion that is grantingg 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 twig 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
commencing work or recording our Notice of Commencement.
S
5 ure of ner/Lessee Contractor as Agent for Owner ature ntractor/License Holder
STATE OF COUNTY OF
r n COUNTY OF STATE OF FLORIDAWkt t
The for ing instr meI/n�1llw s acknowledged before me The forgoing Instrume t as ac`kn'owledged before me
this�iday of 20 aby this.+Z day of � 20 LJ by
(Name of per5 acknowledgi g) (Name
n of person cknowledgi )
(Signature of Notary Public- tate of Florida) (Signature of Notary Public-4ate of Florida)
Personally Known x OR Produced Identification Personally Known OR Produced Identiflt_ation
Type of identification Prod ucr „�L�.� Type of Identification Produc 1�d�1�s
Commission No. Commission No, IIrT RDMA
Cawar�agi9$= clam Fri
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS