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HomeMy WebLinkAboutBuilding Permit Application t -: A LAPPUCABIE INFO MUST t3E fAMPUETED FOR APPUCATION TO:BE ACCEPTED DaEe. �D Peimit'NUmber.; Building Permit.Applicatitl' Plcnnrng cnd Development 5ervlces: #agC(�ny and Cade;•8`egulotJgr!Division 2300 1,ghila avenue,Fort Pierce A'34982 Phone:(772}46245 `Fax.(772)462-ups CommerCial,. Resldntial PERMJT:APPLICRTIQ:N FOR, Ste' Address Legal Description: S' Cf. -- . f Tax IQ#.. �a� oa' -.C�Oe-� bbl?'"or_ _ lot No Property __ __ . '5ite_Pl4n`Name _ Block=No. Project Nacre 1 Setbacks, Frorrt_ Back RfkhtSide.• wft side:_ . r_��i c► f-- _ �- �ctc� ,ne �{-- off- S-r-o N ._ 15 deer . 14 plonaworkiwo)e-performea_ un_.er t op .-c ec a. t .a_app-y ,_Nlecfianical _Gas=Tank: =Gas;Piping _Shutters Windows/Doors 0ecft�c _Plumbing _Sprinklers _Generator ° Roof' Tatal S.q-Ft of Construction: Sq.Ft:of Firstfl4or - Cost of Constructlgn $: Ubliiites _;Sewer Septic B;uilding;Herght .. Nemama:�: G1. . A` ie ► Ue Name:, 1. _ .Address:. $Dei 3 5' "�'�t'��i-''f".- :Company: Y` 14t no Ctyi ��G�'E'-' � _��LICt:,'t� _. _ State Fl.. Address: 511A I Wh!'G'Qn414 4*1 _d 2i °Code: Fax : ._- .._ CityR'�-l'g' .c '2 Staley: o" -... : - Phone Na. -f(pLv 1149tC2Zip Code, Fax:; ' E=Malt' Phone No('-V7= _'fita�:3�(or tl:ia fe..e simp!e Titfe.Noider-on'next;page(rf different E'-Mail: r!i - tl•Cs from the Owner listed: above); State or Coun y license: • If value of wrtst`uctWQ jS 2500 or more,a:RECOR!>Ed Notice of Cofitriencement is required. G, a �DESIGNERjENG.INUK' "Not Applicable: MORTGAGE Cf•JMPANY:. ' __Not Applicabie .Name tame: Address _- :Address City' _ .. State. C State: Zi ,one:, Zip: Phone.. P' FEE°SIMP,LE TRLE MQLOER: _._.Not Applicable' BONGING C011tIPANY.; _.._Not _Pp 10 , Name: Name: .. Address: _ Address,l City_ Cttys. . _ Zipf Phone; Zip{ Phone_ - {' 0WNER/i ONTRAC-,rOR OFIDUIT.Appirc400n is hereby made°to obtain apermit to do the work and tnstallatian as indicated:_ ` 1'certify that no:work or__instaliatio'h has,eommenced prior tbahe;issuance of a perp it: St Lu Conn��yy.makes na.represen anon that is granbng;a permitwil)authorize tfie perrritt holde'to:buiid:the subject structure which is:m'conflict�ivith an applicable Home Owners Assoctattan rules,bylaws ar,and:covenantsAhat may.restrict de prohibit such: Y structure._Ptease wnsuit arith your Norrie Owners,Association and revieniv your deed for any reArk ions which may apply.' do c6mideration of the granting of this retxuesteil permit,l do herefsy'agree thati",will to all respects;performs the work in accordance with,the-approved plans,the Horida euitding;Codes;and St:.lucie CouriW Amendments: E. i' The fallowing buiit iitg permit applicatians.are:exrsmpt from::undergoing a fuihconcut,rkhcy review t, additions; accessory structures;swim_rrting ponis,fences,walls,signs,screen rooms.a nd`aaessorwuses to another non=residential use 4 _ WARNING TO:OWKER Your faiiure'to`Record a Ndtfce of Commencement ma ,:result in'_ our-a in twice for improvements fo.your,properry.A'Notice of t`om nencement must be recorded and posted on,he iobsite before tFie first,"spection if�you intend to obta n finartcih6 co nsult With fender or an attorney f efore com'mencin work or recurdin o r Notice,of'Comme icement. = ` Signature` Owner/Agent(lessee Signature of Co or/License Holder, l.' STATE�F_FIORI©A - STATE_OF FLORIDA couNTv of [ r„�c�a co�inm(oF - - The:for�D�i�ng instrurrient was acknowledged before.rne. The fargging instrument was acknowledged befog me thIs; 't'*8ayof . 2i1$ by tfiisaay.of 2o�;x by _. Qt 1 • {Name of _e cimowted n }: Name of o acknowiedgtn ..��, (Signafure of_Natary -State of Honda) (Signature of Notary Public State'6f.Flor1da) Personally'Known -- DR Produced tdenttf%cation Personally Known ✓ OR Producedtdentification. - _ Type ofidentifi Type of ideritification.Produced _ ,`i�p�"�s'•.. DEBORA} RU�SELL - Corstmission N =:°+ .`�? l Gomrriission No: ' DEBORAR�`IELL _ clary Public : Qi Florida, g,- 34 G'ommission#FF 179630 :° Notary-Public State of Fiuritla r o.� ':•;fi o�°P y Cam Ez gyres No,04 30 2018 REViE1hlS 1508-. FOLANS V E)74°f>f l 5EA lIRPTlE Ovt CCIUWTER REVIEW itE171EW REVIEW' !t DATE RECEIVED- CO.IUtP.LETED_ n v.. i