HomeMy WebLinkAboutBuilding Permit Application t+
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DES1GNIr NE R.- t APPI MORTt:3AGE coMPANIt: Not Appli ble
Name: L dame:
Address; { 1 Address
City; State- CSty: 'State _
Zip: Phone: ZIP, Phone:
FEE SIMPLE MOLDER, #App4m4le BONDING COMPANY: „_Not Applicable
Name: Name:
Address: I Aftem,
City: City: !(
Zip: d'+ Phone: Zip: Phones ,l
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I caMy that n k or installation has ImenzAd pi tor to the tstuance of i pefmht
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St t e Chun akes na rep�a e t tbott a !s etattting a ermlit a orize the pefmJt holder to build the eject situ�' ure
ivhic is In colt cG with an t sp10 1 rs fps tios►!flies,by aWs+pratsd ttrvenAnti u1E may rt Eridt ar prcttttb such
structure,Plea cgrssuiI wtt#t your home is A:ssoclacian anci raVtew your,Med for any restrictions"Ileo may apply.
in mnsiderati of the grandrtg of this f d permIL 14*heraby agroa that I wNi,to all respects,ptrform the vrofk
in actnrdanaa the approved pians,th lorWis ilksilding Coders and St Lucie County Amtndments. {'
Thefoblowingb Itc%ngpwrrdtappUcartions gerns%t mundwj afvllconc'urrencyreyltw:room additions,
accessory stfue res,swimming pouts,f 'Watts, L screen roams and accessary uses to another nota-residential use
WARNING C OWNER:Your failure flecortf&Autice of Cornmrnt ement may result In your paving tithe for
imp ovemert to your property.A Lica of Comm anc>M ent must be recorded and posted on tha jobsIte
beP the f1 inspection,If you d to obu in tinancf conwlt wlt lender or an attorney before'!1
Com encln din Notice of C4Metl ent
5ignat. eof d bigU 0 ure Hold �f i
STA OF RIDA STA OF flRIDA
Cott b COU
The forilolas I tru nt was adgxW beforu rine Tho f ng iasttume t was acknowledged before me l
this day 2b by this Aay of 2Q t by
��"�' 4tJ. rte, ���I r �'"''L_"�a'`•� f�''�}�"��` ;'' —
(Narne of pars ackaww le ging) (Nuane of pifon etkhuwledging)
i51gts1titure of tory Puh1Ua State of F#o (Sippature of Wary P hc-State of Efurida)
ParsofWhy linDR Pndfuae+d 1 ntifteation �,__ Perianally Known Qat Produced tdentitrcationZ—
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Typt of ldenUh tlon Produced t_„_„ TYPe of Identification t*toduced p
Comfniss�an t-^ 1} i tornmissson No �a���1��L
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Revlsta071 512014 t�Fsras4;rAattf.tutt 'aaFn t3«u+aW.e,,Mod N4
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REVIEWS FRONT ZONIN SUPERVIS R PLANS VEGETATION SEATURTLE MAN ROUE �
COUNTER RM REV?::1'V REVIEW ROPIEW REVIEW R IEW 1
DATE I
COMPLETE
I NMALS I F
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ALL APPLIC�j LE INFO MUST BE CO LETED FQR APPLICATION TO BE ACCEPTED
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Date: 1 Permit Number:
uilding Permit Application i
Planning an Development Services
Building and ode Regulation Division i
2300 Virgini Avenue,Fort Plerce FL 34 2
Phone:(77 462-1553 Fax: (7721 2-1578 Commercial Residential
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PERMIT A PLICATION FOR: SelecOrom dropbox, click arrow at the end of line ; 1
i a?��1'4F'� `'.•'':�` III
Address: _ 't
n
Legal Descrip ton: P ll
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Property Tax #: Cz_ l `1 c - Lot No. !�
Site Plan Na BI ck No
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Project Name C- i l�
Setbacks F nt Back: i light Side: Left Side: jib{� it
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E XGG- ell C cwr_ o 5 'r I-
W t I C3 L h -�- ( }
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Additional w o e er orme un
r s permit-c ec 'E
VAC a appy:
Gas Tank ❑Ga:,Piping _Shutters t.._.1 Windows/Dors 11'---�1
Electric 0 Plumbing I ❑
g i Spi nklers Generator Roof
Total Sq. Ft of onstruction: Sq. Ft.of First Floor:
O '
Cost of Constr ction:$ J. Utilities: Sewer F Septic Building Heig
r W `�
Name Name: emq Lex-
�t
Address: ri Q(-e—arl (-11-. -=W-lzk Company: V�rrlu_�av_r",1
City: f)s Sta:3:
1 Address: � He-Irl L"�
Zip Code Fax: 1 City: Orr+5� It .(dr- 'tate:
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5' i Zip Cade: ��4g5D Fax:-1 - 5
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+ Phone No.
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er an nexfi ge(if dill arent E-Mail: U C ove] State or County License:S` p_ ill !Eli500 or more, RECORDEI Notice of Commencement is required. }