HomeMy WebLinkAboutBuilding Permit Application I
ALLAPPI,1CA LE INFO MUST BE COMPLETED•FOR APPLICATION TO BE ACCEPTED
Date U Permit Nur ber
IZMIR
Building Permit Application JUN Og 2018
Planning and Development Services
Building and.Code.Regulation.Division Permitting Department
2300 Virginia Avenue,Fort Pierce-FL 34992 hy;qiekunty, FL
Phone:(772)462:1553 Fax: (772)462-1578 'Commercial
PERMIT APPLICATION FOR: TO,SeleCtfrom dropbox, click arrow at the end of line
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Legal.Description:`
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Property Tax;ID°#.s ii JL - Z Lot No:
Site Plan Name:- Block No.
Project,Name: 130 ) _ 111—
Setbacks Front Back: Right'Sid'e: Left Side:
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Additional wor to e ertormed under tis permit=c ec a appy:
VAC GasTank Etas Piping Shutters Q Windows/Doors
_Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq..Ft of Construction: S .Ft.of First Floor:"
Cost of Construction:$ Utilities; Sewer ElSeptic Building Height:
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Name VY,
Addres : ) 1 a Company: ,
City: •��C� State. Addr s V Imo'_.
Zip Code: j Fax: City: ,vim. l tie Stater
Phone No. 117_ S, I�s � Zip Code: I C>l1? Faz1�Z C/1 -1
E-Mail; Phone
Fill in fee simple Title Holder on next.page.(If different E-Mail: - C11w
from the Owner listed above) State or County L cense:
if'value of-construction is$2500 or more,aAECQRDED Notice of Commencement is required.
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INFORM�`.? IQSUPPLEMN7¢L CW .a
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not 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:
Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT .Appiicat'ion is hereby made to obtain a;permit to do the work and installation as indicated.
I certify that no work or installationhas.commenced prior to the issuance of a permit.
St:Lucie:Coun makes no representation thatas;granting a permit will.authorize the permit holder to build the subject structure
which isJh coriict with any applicable Home Owners Association rules,bylaws-or and coven antsAhat,may restrict or prohibit such
structure.Please.consult with your Home.Owners Association and reviewyour deed for,any'mstrictions which may apply.
In consideration of the granting of"this requested permit,,I do hereby agree that I:wiii,in all respects,perform the work
in accordance,with-the approved plans the Florida;Building Codes and St.Lucie Gounty:Amendments.
The following building permit applications are exempt from undergoing a full:concurrency review:room additions;
accessory structures,swimming pools,fences,walls;signs,screenrooms'and accessory,uses to another non-residential use
WARNING 70 OWNER:Your failure,to Record a Notice of Commencement.may result:in your paying twice for
i'mprove cnents to yourproperty.A Notice of Commencement must be.recorded.and posted ori the jabsite
before tie first inection. If you intend to obtain financing,consult with lender ar an attorney before
commenctn or inspection.
recordin . dur'Notice of Commencement.
Signature f O ner/Lessee/Contractor as.. gentforOwner Signature of'Gon r, orjLicense Holder
STATE OF.F�111113�A ' STATE'OF FL0 IDACOUNTY(3COUNTY OF UIL—be
The forgoing instr ent was acknowiedg d; efore me The, going,instrupaent was acknowledge, before me
this l day of OUSV- /701;eu this day of IAC 20 by
M_a(TeALL
VA7
Name of pern.making;statement Name':of per n making statement
Pei sonaliyKnown :OR Produced Identification Personally Known OR Produced identification
Type of identification
Produced Type of'identification
Produced
I;1
(Signature of Notary Public-Sta Fior'
Wit6rine Konger (Signature of Notary Public-State gf,�lorida)
*• I C on#17172112 1*P:Y!{r� Catherine Konger
Commission:No " �tSGY`28 2018 Commission No.. .: CionftEF17237Z
EON660 THRU
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Uiuiu SS?`FLORtDA'NOTARx LLB
REVIEWS FRONT ZONINGFREVIEW
PLANS, VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEWREVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETE
Rev.8/2/17