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HomeMy WebLinkAboutBuilding Permit Application ALL • • I •• • • I •. 4Number: Building • Applicati• Planning and Development Building and Code Regulation Division //Virginia Avenue,Fort Phone: Commercial . . • . t PERMIT APPLICATION FOR: To Select from • •••• , click ftp arrowryry• of -yy ���D ■ ■ +a 1 E � e a A 1� r� ^11g1}'��'I�'�I��yy�;[z���l}�ia7�]y �y ll F If yt�+ ���Y1 '� � g p,} )"i`pTA�l+rl��fi'� t5 s�>rr�' ® � .� .,ani I ,��if,�4l�.£�lfCl',CSS"U1�ih'.��Flhf '..,;/S!��r�7Y� �•���.+�.�'�'�'S"»��Q�'N^k'llu3s'l�w!} ��� Address: BlockLegal DescriptionUff f ]L LA Site Plan Name: • SetbacksProl IJ . .- i:i!cA:)M':.�yoi.U r:"+::. ,•i'•-•�N�' ^'a'(+rYti, � i�•CZlki 'est",Fy.:- ^..:r,} +te 7y?�.)•:;rv� ,c+ .i, - d:r+.5're-t'Ni n r,.'i rr,rz?Gar,"TiT%6,�'�':nd•-•s. ,::t i ht;' .yu._.s7,•. •S,�- >t ,-�.. �. 1,.L4t t�'� 'lN, X+''L �i 1 fr•ir J` •�y•i�rC s I�• -r"1'�'�Tt l }- .,y r�d �,r � � I . 7 4^�b,,.��ai.S`�'r ��,s 1ypi 1f+e.�ul(,� r�T.7;=,�i;cnir'� \ t�G•Yi �•�;.t��t. i rxfl�.s�s,0�utrs. .Ys.fl17 'w J'�S i b,t i' f'� �t,r .F1�i:� �� ° p Q^���.Lrs���1 �'dit '%�` q�r:';�...e � ,i?!�:.sr•�, .l';��tY_, �FC,�i!ti?',:,.>� u`.l 'r'`S}� t ,!4r pi��lt�c��.^v.,, �t'�� ", �[ �'� h��� rx a t"); ','�(\"�,,�,t\ Gt��d r r ,a,u�- .I,L�):•n r �i, ��„`F_t.{r.h. 7+•.y_•-.t..t+�:. f 'f}:•� ro• f• •` I, �r't� � � $'��"�t�[.�- r")�`�S��F.'r_;w,�t��'���f��,�s`h�ry!`p�tiE v�tr y„rr��5�> r-:tn�pr.�%�r�f"�'�fir` �, u'��fi�;c+'"u;�'v� .J..e3 n c`''NG�:l��i:i� ��ti'..�� ��1}:w��.,d:. 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WIN Al i It R=IN ,WC N VFMAig i.M�� TW- 4 DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: 1� Not Applicable Name, Name: Address; Address: City: State', City: State: 7-1p: Phone Zip:_Rhone:il', FEE.SIMPLE TITLE HOLDER: Not Applicable BONDING compANY- Not Applicable Name: Name: Ad d ress: Address: I it City-, City:_ Zip:, Phone: Zip, bone: I II OWNER/CONTRACTOR AFFIDVIT:*Appl[catlon is hereby made to obtain a permit,to do th6�work and installation as indicated. 1 � I certify that no work or installation has commenced prior to the Issuance of a permit. II St.Lucie County makes no representation that is granting a permit will authorize the peq it ol e'to build the subject structure which Is in conflict with any applicable Home Owners Association rules,bylaws or and covenants"t at may restrlct or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrlctlons which may apply. In consideration of the granting of this requested permit,I do hereby agree that I will,in all res ects, er rm the work County In accordance with the approved plans,the Florida Building Codes and St.Ludle County an s. The following building permit applications are exempt from undergoing a full concurren review:(room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory es to another ron-residential use II I1] WARNING TO OWNER:Your failure to Record a Notice of Commencement may resultilin your paying twice for improvements to your property.A Notice of Commencement must be recorded and pofted on the jobsite before the first inspection. If you intend to obtain financing,consult with lender b:an attorney before commencio&work or recording your Notice of Commencement. p mendm c usesew us Signature f ner/Lessee/Contractor as Agent for Owner Signat re f Con ktor/Licehs'e Holder STAT 0 FLORIDA STAT OF LORIDA COUN9F COU Z F( 11 i1 ) The o for Roing inslEurndPyo�\�YCCMV— 20_�-Jby ent was acknowledged before me The f Ping nstrument was',acknov�edged before me T this this day of 26a by AaNp-?, (af Name of pe on making statement Name of p6rsoi ernent Pers.onally Known '-f— OR Produced Identification Personally Known 11 g 6R:proddl ced Identification Type of Identification Type of IdentIfIcatidn Produced Produced oAt—ML (Signature of Notary Public- or (Signature of Nota' 5tate t-,Vida) Notary P &6zlne Xonger 0111% Catherine lwnge I r commission NoCommission No. s:OCT 28,2018 OCT 28,Zola 11 ND TMR11y BONDED THRU PUIU OTAR, Rr/ IST DAN Ltc I57FLORIDANOTARY,!4& REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION I, SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/1,7