HomeMy WebLinkAboutGrotta 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date, Permit Number:
37711
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:
PROPOSED INPROVEMENT L PF
Address: ,
11
Legal Description:VgAC1V\
Property Tax ID #: 3� L l-iOZ 0136 'D�o— Lot No. 1-7
Site Plan Name: Com( Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
( Eo VA
COIL
CONSTRUCTIO ATION:
,-�_
€
AdaiYiona war to a pe Orme un er t is per mit=c e all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprr��inkl��ers _Generator Roof 3lin (Pitch
Total Sq. Ft of Construction: (500 �C�-YET Sq. Ft. of First Floor:
r
Cost of Construction: $ 6ocn r alL Utilities: _ Sewer _Septic Building Height:
SSEE:
Name
Name:
Address;_zAkL1 I
Company: ,
City: Statt:
Add ress:
City: State:_
_
Zip Code: 3t{LL, Fax:
Phone No. %%7'+ ISA" OMW%
Zip Code: 3 Fax: % fL—�55 L{
E -Mail:
Phone No Z— u `_zs3S
Fill in fee simple Title Halder on next page ( if different
E -Mail SIW t 42�
State or Co ty License OS
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement Is r1quired.
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AL CONST N LIE
DESIGNER/ENGINEER: of Applicable
MORTGAGE COMPANY: of 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
which is in conflict with any applicable Home Owners Association bylaws
rules, 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 undergoinga 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
commeJicinR work or recording our Notice of Commencement.
Signa e o caner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA `
COUNTY OF S luGlP _
STATE OF FLORIDA �)J
COUNTY OF ST.� S} _ (2�
The forgoing in rument wa§ acknowledged before me
this—dayof 20jr2by
The forgo2m instr ent was cknowledg d before me
this dayof 20-Qby
Name of perihn making statement.
Name of per on making statement.
Personally Known OR Produced Identification '7L
Personally Known OR Produced Identification
Type of Identi cation
Type of Identiation
Produced
Produced 1f.�
'(Signature of Nota lic tat of• d) ASHLEYFRKHETTE
^[� NotaryWhllc-State ofFbri
CommissionNo.0 G��'1 ,�. "I Cammissonr00071M9
MY Comm. Expires Feb B. tO
'?crr•:•' Be lidN MaeorelgeW
MmugM1
( nature o Notary P lic Sta of
a
1 C mission N n tO�t� '
ASHLEYFRECH
NotaryPubik-State of i
-_ [ommissisMYGG071
7. My Comm. Expires Feb f,
.. as acP:°B°geON�wgbkatlaW
Ice
]
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
°
DATE
COMPLETED
ev. 8/2/17
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