HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPUTED FOR APPUCATION TO AE ACCEPTED
Date: i `111 Q ._.�.. Permit Number._���1" d 4—..
Building Permit Application
Planning and DeWwnientSe TIM NQ V 17 20l 7
Building and Code Regula#oni Division �• .
2300 VrrginiaAvenue,Fort Pierre FL 34982 ,J-
Phone.CM)462-1S53 Fax(M)452-lws -Commercial Residential.••
PERMIT APPLICATION FOR: To Select from dropbox, dick arrow at the end of line
PROPOSED:-IMPROVEMENT LOCATION:
Address: 36Q d .
Legal Description• -i?- t9 rov—'.. dd '
t G4 ILI
Property Tax iD#: C� -"'C�Cf4" Lot No.
Site Plan.Name: (R� � _ '� Block No.
Project Name:
P -
Setbacks Front Back Rkht.Side:- Left Side'
DETAILED DESCRIPTION DF WORK:
f1rr-J PIF ZAJ P//
CONSTRUCTIONI N FORMATI ON:
Additional work to be mrformedunder this permit--c. all t=appy:
E MVAC Gas Tank nGas Piping - Shutters Wrndows/Doors
0 ,
Electric 1:1 Plumbing FiSprinkiers L�1 Generator 0—Roof
- f
Total Sq.Ft of Construction: S.F't".]of First Floor.
Cost of Construction:$ �d utirojes:LJSewer Septic Building Hem
OWNER/LESSEE. - .CONTRACTOR:
Name /TC �'!'' Name: AX
Address: Gg CTd' 6 Companr- Kf
City: r�d'�a $taate:-,L� Address: E
Zip Cade: 1� 7j`/ fax: ,/tet/`/T CRY.* Ff [moi statm—r- -
Phone No 712— 361,;)-, ;,�-57j Zip Code.,3 6*>" • Fax..?7 bfv
E-Mail: Phone No._ ?�� �t�„'�13 6 /
Fitt in fee simple Tide Holder on next page(if different E-Mail:
from the Owner listed above) State or Cou 'cense:
if value of construction b$25W or more,a RECORDED Notice of Conunencement is required.
s
r
Mai 11$ i
DESIGNER/ENGINEER: _-Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: Stater City State:
zip: Phone: Zip: Phone:
FEE SIMPLE TITTLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:.
Address: ' Address:
City: City: ,
Zip: Phone: Zip: Phone:
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 AssocFation 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,screemroomskand accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your-oaying 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
comrodQcling work or recording our Notice of Commenceii-nent
Si ature of Owner Agent/Lessee Si tore f Contractor/License Halder
STATE OF FLORIDA STATE OF FLO �A
COUNTY OF SSr , v t e COUNTY OF
0-
The forgoing instrument was acknowledged before me The forgoing llnstru rT t was acknowledged before me
ihis`�day of_ 't.)of _ -20 14 by this �1'1 ..day of N�V ,20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public State of Florida I (Signature of Not Public-State of Florida)
Personally Known OR.Produced Identification Personally Known OR Produced Identification
Type of Identification Produced I- Asx Type of identification
6
DEANNA MARIE GIVENS !u "" DEANNAMARIEGIVEPiS
Commission No. ^' ': My(�S�g[I SION#GG 02242? ( Commission No.El'�. _s: MY COMP�G1eay#GG 022023
11`� ;< EXPIRES:December 96,2020 l = • = EXPIRES:December 16,2020
N� otary Public Undenrrit r, '%, �fro;' Bonded Thru Rotary Public Undenvdters
BondodThruN
Revised 07/15/2014 ^
REVIEWS • FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS