HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
J
Building PeApplication
Planning and Development Services
Building and Code Regulation Division
0 Virginia inia Avenue, Fort Pierce FL 34982
Phone: (772) 462-155 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION :
. y
Address: UID07 TQaSau
Legal Description : ,\
y
Property Tax ID #6. � � � .,�`� Lot No. 9
Site Plan Marne: Block No.
Project Name.-
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION F WORK:
{
CONSTRUCTION INFORMATION :
Additional or t erformed urn r t i permit — check all - apt
[:IHVAC GasTank Gas Piping Shutters Windows/Doors
Electric ElPlumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction : Sq. Ft. of First Floor: --...,.
UCost of Construction : $ Utilities: � Sewer � Septic Building Height:
OWNER/LESSEE : CONTRACTOR :
Nam ee . k rye ig- ' old Ierne.
Company:Address-, q -�? Co
Cit . f State: Address: () /0� O
Zip Code. Fax: City: �� LU
� State;
Phone No. ' "" � � - Zip
Code:
d : x- 6
E-flail: Phone No.
o. �
Fill in fee simple Title Holder n next page if different E- `fail: 4
P P .from the the Owner listed above) Stater Coon � � : , 08 ?o t License: � T.., .
If value of construction i $ 500 or more, a RECORDED L ED otic of Commencement is required.
FOR
SUPPLEMENTAL CONSTRUCTION LIEN IrN MATION
DESIGNER./ENGINEER: Not Applicable MORTGAGE COMPANY-. � Not Applicable
Name: Name:
Address: Address:
City: State: City; .Mate
Zip: Phone Zip: Phone:
FEE SIMPLE TILE HOLDER:+ Not Applicable BONDING COMPANY: Not Applicable
Name: me:
Address. Address,:
City: city:
Zip: one: ` #�
Zip: hone.'
OWNER/ CONTRACTOR AFFI IT: Applicafton is hereby made to obtain a permit to do the work and installation as indicated.
l certify that no work or installation has commenced prior to the issuance of a permit.
,fit. Lucie Coon makes no representation that. is granting a permit Willi authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules laws or and covenants that may restrict or prohibit such
structure. Please consult with our Hone {owners Association and review your deed for any restrictions which may apples
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 cone rrency review: rooter additions,
accessory structures, swimming gaols, fences, walls, signs, screen rooms and accessoTy 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 Commencementmust 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 or ecording your Notice of Commencement. -0�.......
Signature of er Lessee/Contractor as Agent for Owner Signature o r U nse Helder
STATE of FLORIDA STATEFLORIDA
CO T F U C COUNTY OF
The for&oing lnstru e t was a norlede efore e
this .day of . ,
The forgoing lnstrun t was ac olede fore me
�{ F by this " da of `V ...r 20 by
; �,� --.. t ,
r
. r
Marne of person ma*ing statement Name of perso n state rent
Personally noun Produced Identification Personally Known o Produced ldentificabon
Type of Identiflo4tlon Type of ldenfificati6h
Produced Produced
Edk
r
e
fit
i , 1 442
low*111% Will
(Signature of Notary Public- stat F - nature of Notary Public- Mate c �. � �� NOW
minion -
_ = off' tru .
=l UP4r�." MW 96mission �"+io. �t�, �ealComm . = w
ssion No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REND REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17